## Diagnostic Criteria and Features of Preeclampsia **Key Point:** Preeclampsia is defined by new-onset hypertension (≥140/90 mmHg) after 20 weeks gestation plus proteinuria (≥0.3 g/24 h) or signs of end-organ dysfunction. Hypercalcemia is NOT a feature; in fact, hypocalcemia may occur. ### Recognized Features of Preeclampsia | Feature | Mechanism | Clinical Significance | |---------|-----------|----------------------| | Hyperreflexia + ankle clonus | Cerebral edema, hyperexcitability | Sign of severe disease; eclampsia risk | | Elevated serum creatinine | Renal endothelial dysfunction, reduced GFR | Indicates renal involvement | | Thrombocytopenia | Platelet consumption, HELLP syndrome | <100,000/μL = severe feature | | Hypocalcemia (NOT hypercalcemia) | Increased urinary losses, altered metabolism | May worsen neuromuscular irritability | **High-Yield:** The HELLP syndrome triad (Hemolysis, Elevated Liver enzymes, Low Platelets) is a severe manifestation of preeclampsia, NOT a separate entity. Thrombocytopenia is a cardinal sign. **Clinical Pearl:** Hypercalcemia is associated with hyperparathyroidism and malignancy, NOT preeclampsia. Students often confuse mineral metabolism in pregnancy — remember that preeclampsia causes *reduced* calcium reabsorption and *increased* urinary losses. **Warning:** Do not confuse hypocalcemia (seen in preeclampsia/eclampsia) with hypercalcemia (seen in granulomatous diseases, malignancy, vitamin D toxicity).
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