Preeclampsia is diagnosed based on which combination?

• A. New-onset hypertension after 20 weeks with proteinuria or organ dysfunction
• B. Chronic hypertension before 20 weeks
• C. Gestational hypertension after 32 weeks
• D. Postpartum hypertension with edema

Answer: (A)

Preeclampsia is diagnosed when there is new-onset high blood pressure after 20 weeks of gestation together with either protein in the urine or signs of organ dysfunction. The timing matters—preeclampsia develops after mid-pregnancy, not from chronic hypertension present before. If proteinuria is present (for example, 300 mg or more in a 24-hour urine collection, or a protein/creatinine ratio of 0.3 or higher, or a positive dipstick with confirmatory testing), that alone meets the criteria alongside the hypertension. If proteinuria isn’t present, there must be evidence of organ dysfunction, such as impaired liver function (elevated liver enzymes), kidney problems (creatinine rise), low platelets, pulmonary edema, or new neurologic symptoms. The other scenarios—preexisting chronic hypertension, gestational hypertension without proteinuria or organ dysfunction, or postpartum hypertension with edema alone—do not fulfill the diagnostic combination for preeclampsia.