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Assesses the diagnostic criteria for preeclampsia and the presence of severe features using ACOG Practice Bulletin No. 222 (2020): hypertension after 20 weeks with proteinuria or end-organ dysfunction, with severe features including BP ≥ 160/110, thrombocytopenia, renal insufficiency, liver involvement, pulmonary edema, and cerebral/visual symptoms.
Preeclampsia = hypertension (≥ 140/90 after 20 weeks) + proteinuria (≥ 300 mg/24h, PCR ≥ 0.3, or dipstick ≥ 2+) OR end-organ dysfunction; severe features counted individually
Severe features: SBP ≥ 160 or DBP ≥ 110; platelets < 100,000/µL; creatinine > 1.1 mg/dL or doubling; transaminases ≥ 2× ULN; pulmonary edema; new headache unresponsive to medication; visual symptoms.
ACOG PB 222 (2020) defines preeclampsia as gestational hypertension (≥ 140/90 after 20 weeks) accompanied by proteinuria (≥ 300 mg/24 h, protein:creatinine ≥ 0.3, or dipstick ≥ 2+) or, without proteinuria, by end-organ dysfunction (thrombocytopenia < 100,000, creatinine > 1.1 or doubling, transaminases ≥ 2× ULN, pulmonary edema, new headache unresponsive to treatment, or visual symptoms). Severe features additionally include SBP ≥ 160 or DBP ≥ 110. This calculator counts severe features and reports preeclampsia status.
Specialty
ObstetricsCategory
Obstetrics & GynecologyDifficulty
Basic
Estimated Time
30 seconds
Version
1.0
Last Updated
2026-08-16
Formula
Keywords
Normal Range
Severe features: SBP ≥ 160 or DBP ≥ 110; platelets < 100,000/µL; creatinine > 1.1 mg/dL or doubling; transaminases ≥ 2× ULN; pulmonary edema; new headache unresponsive to medication; visual symptoms.
| Classification | Range |
|---|---|
No preeclampsia criteria not met | 0 features |
Preeclampsia without severe features | 0 severe features |
Preeclampsia with severe features prompt delivery planning | ≥ 1 severe feature |
Assesses the ACOG (2020) diagnostic criteria for preeclampsia — new-onset hypertension after 20 weeks with proteinuria or end-organ dysfunction — and counts the number of severe features present to guide management and delivery timing.
Preeclampsia requires hypertension (≥ 140/90 after 20 weeks) plus proteinuria (≥ 300 mg/24 h, PCR ≥ 0.3, dipstick ≥ 2+) or, without proteinuria, any end-organ feature. Severe features — SBP ≥ 160 or DBP ≥ 110, platelets < 100,000, creatinine > 1.1, transaminases ≥ 2× ULN, pulmonary edema, new headache, or visual symptoms — warrant inpatient care and delivery planning.
Standardized ACOG criteria for preeclampsia and its severe features drive critical decisions about inpatient management, magnesium sulfate seizure prophylaxis, antihypertensive therapy, and delivery timing, reducing maternal and perinatal morbidity.
A 31-week patient has BP 150/95 mmHg, 2+ proteinuria on dipstick, platelets 150 ×10³/µL, and creatinine 0.9 mg/dL, with no other severe features.
Inputs:
Preeclampsia without severe features (0 severe features) — manage with maternal and fetal surveillance; delivery typically planned at 37 weeks.
Yes — new-onset hypertension plus any of thrombocytopenia, renal insufficiency, liver involvement, pulmonary edema, or cerebral/visual symptoms meets criteria even without proteinuria.
SBP ≥ 160 or DBP ≥ 110; platelets < 100,000/µL; creatinine > 1.1 mg/dL or doubling; transaminases ≥ 2× ULN; pulmonary edema; new headache unresponsive to medication; and visual symptoms.
Disclaimer: This calculator is intended for educational and clinical decision support purposes only. Preeclampsia diagnosis and management require complete clinical assessment; treat severe hypertension promptly regardless of the calculated feature count.