Preeclampsia: Hypertension >140/90 with proteinuria of at least 0.3g/24h
Severe preeclampsia: Preeclampsia with hypertension >160/110 or proteinuria >5g/24h or multiorgan involvement
Impending eclampsia
Severe preeclampsia with signs of cerebral affection like visual disturbancies, headache, increased reflexes, and clonus
Eclampsia: Convulsions in any woman who has, or then presents with, hypertension in pregnancy of any cause

Symptoms other than hypertension and proteinuria in severe preeclampsia
Oliguria (<400 ml/24h)
Cerebral signs (headache, blurred vision, altered consciousness)
Pulmonary edema, cyanosis
Epigastric or right upper quadrant pain
Impaired liver function
Hepatic rupture
HELLP syndrome

Fetal complications of severe preeclampsia
Intrauterine growth retardation
Premature delivery
Abruptio placentae
Fetal distress

Maternal complications of severe  preeclampsia
Cardiovascular dysfunction (cardiac failure, hypertension)
Renal dysfunction (oliguria, reduced GFR, elevated creatinine, acute tubular necrosis, cortical necrosis)
Respiratory dysfunction (ARDS, pulmonary edema)
Hepatic dysfunction (elevated liver enzymes, subcapsular hematoma, HELLP syndrome)
Cerebral dysfunction (encephalopathy, ischemia, cortical blindness, retinal detachment, infarction, hemorrhage, edema, eclampsia)

”Delivery of the fetus and placenta is the definitive management of severe preeclampsia. Once severe disease has been established and is progressing, delivery of the fetus and placenta must be accomplished to limit maternal risk.”

HELLP syndrome
Microangiopathic hemolytic anemia, consumptive thrombocytopenia, liver dysfunction
4-12% of patients with severe preeclampsia, 30% occur postpartum
DIC often secondary to placental abruption, sepsis or fetal death
Platelet count indirectly proportional to severity of disease
Differential diagnoses: TTP, HUS, SLE, sepsis, acute fatty liver of pregnancy
Complications: ARF, ARDS, hemorrhage, placental abruption, rarely liver hematoma with rupture

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