Differential diagnosis for pre-eclampsia

Pre-eclampsia can involve high blood pressure after mid-pregnancy, protein or other changes in urine, headache, visual disturbance, upper abdominal pain, swelling, or changes in liver, kidney, or blood-platelet results. Symptoms and test results can overlap with chronic hypertension, kidney disease, liver or gallbladder problems, migraine, low platelets, or a pregnancy-related liver and blood disorder. A single reading or symptom does not settle the diagnosis.

Clinicians compare current findings with your earlier health and pregnancy records. They may repeat blood pressure, check urine, order blood tests, monitor the baby's growth and heart rate, and use ultrasound when needed.

Attend recommended antenatal reviews and bring a list of medicines, previous blood-pressure readings, and symptoms. Your maternity team may arrange observation, medication to control blood pressure, or closer fetal monitoring. The plan depends on pregnancy stage, test results, symptoms, and the condition of you and the baby. Discuss induction of labour or caesarean section only after your team explains why either may be safer.

Contact your maternity unit urgently for a severe or persistent headache, flashing lights or blurred vision, severe pain below the ribs, sudden marked swelling, shortness of breath, heavy bleeding, reduced fetal movement, or feeling seriously unwell. Do not wait for a routine visit when these symptoms occur. Pre-eclampsia can worsen without dramatic symptoms, so follow the monitoring plan even when you feel well.

Which findings support or argue against pre-eclampsia? Which tests need repeating? What blood-pressure symptoms require immediate contact? How will the baby's growth and wellbeing be monitored? Under what circumstances would induction or caesarean birth be discussed?