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American College of Obstetricians and Gynecologists (ACOG) Current Guidelines for Identifying Preeclampsia

ACOG's recommended guidelines for identifying preeclampsia in clinical practice and frequently employed in research protocols are:
  • Systolic blood pressure of 140 mm Hg or higher or a diastolic blood pressure of 90 mm Hg or higher occurring after 20 weeks of gestation in a woman whose blood pressure has previously been normal
  • Proteinuria, with excretion of 0.3 g or more of protein in a 24-hour urine specimen
For diagnosing severe PE, ACOG recommends one or more of the following:
  • Systolic blood pressure of 160 mm Hg or higher or a diastolic blood pressure of 110 mm Hg or higher on two occasions six or more hours apart in a pregnant woman who is on bed rest
  • Proteinuria, with excretion of 5 grams or more of protein in a 24-hour urine specimen or 3+ or greater on two random samples collected four or more hours apart
  • Oliguria, with excretion of less than 500 mL of urine in 24 hours
  • Pulmonary edema or cyanosis
  • Impairment of liver function
  • Visual or cerebral disturbances
  • Pain in the epigastric area or right upper quadrant
  • Decreased platelet count
  • Intrauterine growth restriction
For diagnosing eclampsia, ACOG recommends the identification of new-onset grand mal seizures in a pregnant woman.