"alarm findings" of preeclampsia

Q: All of the following are considered "alarm findings" of preeclampsia EXCEPT? (select one)

A) severe headache

B) blurred vision

C) epigastric pain

D) confusion

E) leg edema

Answer: E

Alarm findings in preeclampsia refer to the 'severe end of the disease spectrum.' It is a clinical emergency. This includes persistent and/or severe headache, visual changes such as scotomata, photophobia, blurred vision, temporary blindness, upper abdominal, retrosternal, or epigastric pain, confusion, and/or altered behavior, dyspnea and/or orthopnea.

The objective of this question is to emphasize nonspecific symptoms such as epigastric pain. Reflux is common in most pregnant patients and may go unnoticed but unbearable and/or persistent epigastric pain should be evaluated closely. Moreover, reflux symptoms are usually more pronounced at night.

Leg edema is almost universal in all pregnant patients

#ob-gyn

References:

1. Shi JM, Yang Z, Chen L, Wang JL. [Early warning signs of severe preeclampsia]. Zhonghua Fu Chan Ke Za Zhi. 2009 May;44(5):337-40. Chinese. PMID: 19573307.

2. Lambert G, Brichant JF, Hartstein G, Bonhomme V, Dewandre PY. Preeclampsia: an update. Acta Anaesthesiol Belg. 2014;65(4):137-49. PMID: 25622379.