Identifying atypical preeclampsia: A diagnostic challenge

Abstract

Preeclampsia is a multi-systemic syndrome of variable severity, pregnancy specific, consequence of an abnormal vascular response to placentation, with increase in peripheral vascular resistance and endothelial dysfunction. In the majority of cases, it will present with gestational hypertension and proteinuria, after 20 weeks. Nevertheless, in other cases, it has presented as an atypical form (with absence of hypertension and/or proteinuria) behaving like preeclampsia with severe features. We present a 35 year old G3P2002 at 36 weeks 3 days gestation, with normotensive to mild range blood pressures, absent proteinuria, and acute kidney injury (AKI). We will discuss her management with a trial of furosemide and subsequent delivery based upon the current criteria for diagnosis and management of preeclampsia.