Study note
Obstetrics & GynecologyHypertensive Disorders in Pregnancy

Alarming symptoms of pre-eclampsia

THE CONTEXT
Severe symptoms may occur singly or together and are usually associated with acute onset of the syndrome.

Neurological and urinary symptoms

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Headache may be located over the occipital or frontal region, and sleep may be disturbed.
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Diminished urinary output is alarming; output below 400 mL in 24 hours is very ominous.

Abdominal pain

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Acute epigastric pain with vomiting, sometimes coffee-colored, is attributed to hemorrhagic gastritis.
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Right upper quadrant pain is attributed to subcapsular liver hematoma formation.

Visual symptoms and recovery

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Visual symptoms include blurring, scotomata, dimness of vision, and occasionally complete blindness.
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The stated causes are retinal vessel spasm with retinal infarction, occipital lobe damage with vasogenic edema, and retinal detachment.
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Vision is usually regained within 4–6 weeks after delivery.
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Retinal reattachment occurs after delivery as edema subsides and blood pressure normalizes.
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