It’s No Longer Called PIH…and Everything Else You Need to Know About Preeclampsia

It’s actually not been called “PIH” for years now 😉 and I’ve been reminded of this at the last few AWHONN conferences and conventions.

Preeclampsia is something that all of us deal with, regardless of what area of obstetrics you practice in. We seem to be seeing more and more patients with high blood pressure, and there doesn’t seem to be one way providers deal with it. It’s no wonder we get confused!! Last year after the 2014 AWHONN Convention I put together a handy little blog post about high blood pressure. Another year, another convention, and now another (updated) blog post 😃 I hope someone out there finds this useful…

Some key points that I learned (or re-learned) at the 2015 AWHONN Convention that I think every nurse needs to remember:

  • The diagnosis of severe preeclampsia is no longer dependent on the presence of proteinuria. Do not delay management of preeclampsia in the absence of proteinuria.
  • There is preeclampsia with or without severe features (so no more “mild preeclampsia”).
  • If a patient has “white-coat syndrome” (she’s nervous about being in her provider’s office), she’s more likely to end up with gestational hypertension or preeclampsia later in her pregnancy.
  • These are the characteristics of severe preeclampsia:
    • Hypertension: systolic >160 or diastolic >110 on two occasions at least 4 hours apart while the patient is on bed rest (unless antihypertensive therapy is initiated before this time).
    • Thrombocytopenia (platelet count <100,000).
    • Impaired liver function (elevated blood levels of liver transaminases to twice the normal concentration), severe persistent RUQ or epigastric pain unresponsive to medication and not accounted for by alternative diagnoses, or both.
    • New development of renal insufficiency (elevated serum creatinine greater than 1.1 mg/dL, or doubling of serum creatinine in the absence of other renal disease).
    • Pulmonary edema.
    • New-onset cerebral or visual disturbances.

Here are some online resources that will tell you everything you ever wanted to know about high blood pressure and pregnancy:

I pulled this directly off of ACOGs Frequently Asked Questions page, and I thought it was a great quick reference guide:

Until my next delivery ❤

10 thoughts on “It’s No Longer Called PIH…and Everything Else You Need to Know About Preeclampsia

  • June 22, 2015 at 3:06 pm

    So good! Love this update and reminder.
    Soon could you post something on GDM?

  • June 22, 2015 at 7:15 pm

    You’re a rock star Shelly! This is so useful and I can’t wait to share it :)

  • June 23, 2015 at 3:35 am

    Thank you so much for spreading the word about the latest information on preeclampsia!

  • June 25, 2015 at 12:39 am

    Very helpful! I had severe preeclampsia and never had any swelling. I actually lost 7lbs the week before my emergent section due to N/V from the horrible headaches. My protein was high, but not terrible. My Dr kept saying that I didn’t present like a typical preeclampic patient, thankfully she looked at the whole picture.

  • June 25, 2015 at 12:22 pm

    great info! and for those looking for patient ed materials to fill the”recognition” gap which so many adverse outcomes can be attributed to, checkout Evidence-based education tools available for only cost of shipping.


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