Screening and diagnosis

Classification and risk stratification

Perioperative care

Quality improvement

Patient education

Nonpharmacologic interventions

Therapeutic procedures

Respiratory support

Follow-up and surveillance

Specific circumstances

Preventative measures

Medical management

Surgical interventions

Inpatient care

Diagnostic procedures

Diagnostic investigations

Insufficient evidence to make a recommendation.

Strongly favor this test or intervention.

The ACOG criteria for preeclampsia calculator determines if a patient meets the diagnostic criteria for preeclampsia by assessing three key metrics: blood pressure, proteinuria, and symptoms associated with new-onset hypertension. Each of these factors is evaluated using specific conditions that are assigned points reflecting their clinical importance.

For blood pressure, two conditions are examined:
- A systolic blood pressure of 140 mmHg or higher, or a diastolic blood pressure of 90 mmHg or higher (based on two measurements at least four hours apart in a patient with previously normal blood pressure, after 20 weeks of gestation) scores 3 points.
- A more severe case, where the systolic blood pressure is 160 mmHg or higher, or the diastolic blood pressure is 110 mmHg or higher, scores 20 points.

Proteinuria, the presence of excess protein in urine, is assessed using different methods:
- No proteinuria scores 0 points.
- A level of 300 mg or more in a 24-hour urine collection, a protein/creatinine ratio of 0.3 mg/dL or more, or 2+ on a dipstick (in circumstances where other methods aren’t available) each score 2 points.

The presence of new-onset hypertension combined with any one of the following conditions also affects the score:
- Thrombocytopenia, indicated by platelet counts less than 100×10⁹/L, scores 2 points.
- Renal insufficiency, evident either by a serum creatinine level higher than 1.1 mg/dL or the serum creatinine concentration doubling without other renal issues, adds 2 points.
- Impaired liver function, noted by elevated liver transaminases to twice their normal concentration, scores an additional 2 points.
- Pulmonary edema scores 2 points.
- New-onset headaches that don’t respond to medication and can’t be explained by other conditions, or visual symptoms, both add 2 points.

Scores from these categories are summed to get a total. In interpreting this total score:
- A score of 5 or more indicates the diagnostic criteria for preeclampsia are met.
- If the score reaches 22 or more, it suggests the criteria for severe preeclampsia are met.
- A score below 5 suggests that the diagnostic criteria for preeclampsia are not fulfilled.

This systematic approach helps clinicians make informed decisions about the presence and severity of preeclampsia, guiding effective patient care.

The ACOG diagnostic criteria for preeclampsia is a clinical calculator developed by the American College of Obstetricians and Gynecologists. It is specifically designed for pregnant women and is used to diagnose preeclampsia, a potentially dangerous pregnancy complication characterized by high blood pressure. 

The clinical utility of this calculator is to aid in the early detection and management of preeclampsia, which can help prevent severe complications such as eclampsia, organ damage, and preterm birth. The ACOG criteria for preeclampsia include factors such as blood pressure measurements, proteinuria, and signs of organ dysfunction.

There are no specific exclusion criteria for the use of the ACOG diagnostic criteria for preeclampsia. However, it is important to note that this calculator is only applicable to pregnant women and should not be used in non-pregnant individuals or for diagnosing other conditions.

ACOG criteria for preeclampsia

Preeclampsia

Diagnostic criteria

Setting of care

Management of severe hypertension

Management of non-severe hypertension

Management of non-severe hypertension, choice of agent

As per AAPA/ABC/ACC/…/PCNA 2018 guidelines, 

Low-dose aspirin

Low-dose aspirin, general principles

Vitamin D supplementation

Indications for screening

Indications for screening, at-risk population

Magnesium sulfate

Intravenous nitroglycerin

Severity grading

Management of non-severe hypertension, contraindicated agents

Low-dose aspirin (diabetes)

Calcium supplementation

Exercising

Postpartum antihypertensive therapy

Long-term surveillance

Timing of delivery

Laboratory testing

Management of non-severe hypertension, indications and targets

Abdominal ultrasound

Platelet transfusion

Preconception counseling

Indications for screening, general population

Breastfeeding

Low-dose aspirin (history of hypertension)

Bed rest

Plasma expansion

Blood pressure monitoring

BP monitoring

Low-dose aspirin (advanced age pregnancy)

Screening for proteinuria

Postpartum monitoring

Weight control

Indications for screening (intrahepatic cholestasis of pregnancy)

Fetal evaluation

Thromboprophylaxis

Electrocardiogram

Updated 2024 SOMANZ guidelines for the prevention and management of preeclampsia


Preeclampsia

Guidelines

Key sources