Diagnosis of hypertensive disorders in pregnancy: an update

Hypertensive disorders occur in up to 10% of pregnancy and can seriously affect the mother and fetal health. Pre-eclampsia (PE) and eclampsia are the most severe forms of hypertensive disorders and are associated with short- and long-term sequelae. PE is defined by the presence of blood pressure elevation (>140/90 mmHg) and relevant proteinuria (more than 300 mg/24 h) or, in the absence of proteinuria, the increase of creatinine concentration or a low platelet count or the increase of liver transaminases or presence of pulmonary edema, visual disturbances, neurological signs or utero-placental dysfunctions that lead to felt growth retardation. Eclampsia is a convulsive condition associated with PE or haemolysis, elevated liver enzymes, and low platelet count syndrome. This review aimed at focusing on the correct classification and at accurately describing clinical and biochemical features of PE. Early detection of PE/eclampsia and accurate prediction of maternal risk of developing PE is crucial in the management of this threatening condition.