Presenting Symptom and Other Symptoms and Signs Typically Present

Symptoms and Signs Sometimes Present

Probable Diagnosis

• Diastolic blood pressure 90 mm Hg or more before first 20 weeks of gestation

Chronic hypertension

• Diastolic blood pressure 90-110 mm Hg before 20 weeks of gestation

• Proteinuria up to 2+

Chronic hypertension with superimposed 

mild  pre-eclampsia

• Two readings of diastolic blood pressure 90-110 mm Hg 4 hours apart after 20 weeks gestation

• No proteinuria

Pregnancy-induced hypertension

• Two readings of diastolic blood pressure 90-110 mm Hg 4 hours apart after 20 weeks gestation

• Proteinuria up to 2+

Mild pre-eclampsia

• Diastolic blood pressure 110 mm Hg or more after 20 weeks gestation

• Proteinuria 3+ or more

• Hyperreflexia

• Headache (increasing frequency, unrelieved by regular analgesics)

• Clouding of vision

• Oliguria (passing less than 400 mL urine in 24 hours)

• Upper abdominal pain (epigastric pain or pain in right upper quadrant)

• Pulmonary oedema

Severe pre-eclampsia^a

• Convulsions

• Diastolic blood pressure 90 mm Hg or more after 20 weeks gestation

• Proteinuria 2+ or more

• Coma (unconscious)

• Other symptoms and signs of severe pre-eclampsia

Eclampsia

• Trismus (difficulty opening mouth and chewing)

• Spasms of face, neck, trunk

• Arched back

• Board-like abdomen

• Spontaneous violent spasms

Tetanus

• Convulsions 

• Past history of convulsions

• Normal blood pressure

Epilepsy ^b

• Chills/rigors

• Headache

• Muscle/joint pain

• Enlarged spleen

Uncomplicated malaria

• Symptoms and signs of uncomplicated malaria

• Coma

• Anaemia

• Convulsions

• Jaundice

Severe/complicated malaria

• Headache

• Stiff neck

• Photophobia

• Fever

• Convulsions

• Confusion

• Drowsiness

• Coma

Meningitis^b,^c or Encephalitis^b,c

• Headache

• Blurred vision 

• Vomiting

Migraine^d