Diagnostic_criteria_for_preeclampsia v.2.3

Quantitative urinary protein

Urine Creatinine

Systolic

mm[Hg]

Diastolic

mm[Hg]

Pulmonary edema

Liver transaminases at least twice the upper limit

Proteinuria ≥0.3 g in a 24-hour urine

Dipstick ≥2+

Platelet count <100,000/microL

Serum creatinine >1.1 mg/dL (97.2 micromol/L)

Doubling of the creatinine concentration (no kidney disease)

Headache

Visual symptoms (eg, blurred vision, flashing lights or sparks, scotomata)

Hemolysis

Generalized seizures

Hypertension diagnosed before pregnancy before 20 weeks of gestation and for at least 12 weeks postpartum

Preeclampsia is a pregnancy complication marked by high blood pressure and proteinuria after the 20th week of gestation in previously normotensive women, affects about 5-8% of pregnancies globally and is a leading cause of maternal and perinatal morbidity and mortality. To aid in the prompt diagnosis and optimize health outcomes, we have designed this Clinical Decision Support (CDS) tool based on evidence and guidelines from the American College of Obstetricians and Gynecologists (ACOG). This tool incorporates proposed criteria to ensure accurate and timely detection of preeclampsia. The CDS tool is available in multiple languages, including Swedish, Spanish, English, Catalan, German, and French, to cater to a diverse user base and improve accessibility. Additionally, the tool provides observations related to the differential diagnosis of the four major hypertensive disorders associated with pregnancy: preeclampsia, chronic hypertension, preeclampsia superimposed upon chronic hypertension, and gestational hypertension.

Kevin Arjona

kevin.arjona01@gmail.com

To diagnose preeclampsia (without severe features) based on the American College of Obstetricians and Gynecologists (ACOG) Practice Bulletin

This clinical decision support tool is designed to diagnose preeclampsia without severe features based on the ACOG guidelines, by assessing multiple clinical criteria. It evaluates quantitative urinary protein, urine creatinine, systolic and diastolic blood pressure, pulmonary edema, liver transaminases, proteinuria, platelet count, serum creatinine, hemolysis, and signs/symptoms of preeclampsia and preeclampsia with severe features. Use in pregnant women beyond 20 weeks of gestation who exhibit hypertension.

Do not use in pregnant women with preeclampsia who have severe hypertension (systolic blood pressure ≥160 mmHg and/or diastolic blood pressure ≥110 mmHg) and/or specific signs or symptoms of significant end-organ dysfunction that signify the severe end of the preeclampsia spectrum. Do not use in pregnant women before 20 weeks of gestation

1.-ACOG Practice Bulletin No. 222: Gestational Hypertension and Preeclampsia. Obstet Gynecol. 2020;135(6):e237-e260. doi: 10.1097/AOG.0000000000003891. 2.-Magee LA, Brown MA, Hall DR, Gupte S, Hennessy A, Karumanchi SA, et al. The 2021 International Society for the Study of Hypertension in Pregnancy classification, diagnosis & management recommendations for international practice. Pregnancy Hypertens. 2022;27:148-169. doi: 10.1016/j.preghy.2021.09.008 (King's College London) (King's College London). 3.-Report of the National High Blood Pressure Education Program Working Group on high blood pressure in pregnancy. Am J Obstet Gynecol. 2000;183(1):S1-S22. doi: 10.1067/mob.2000.107928.

openEHR-EHR-OBSERVATION.lab_test_urine_protein, openEHR-EHR-EVALUATION.problem_diagnosis, openEHR-EHR-OBSERVATION.lab_test_creatinine, openEHR-EHR-OBSERVATION.blood_pressure, openEHR-EHR-OBSERVATION.brugada_criteria_for_ventricular_tachycardia, openEHR-EHR-OBSERVATION.glasgow_imrie_criteria_for_severity_of_acute_pancreatitis, openEHR-EHR-OBSERVATION.migraine, openEHR-EHR-EVALUATION.plasmic_score_for_ttp

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