When you compare the two forms of preeclampsia, mild and severe, you will find that the signs and symptoms are similar. The differences lie in the magnitude of the preeclampsia symptoms and the pathological findings.

According to the criteria laid down by the American Congress of Obstetricians and Gynecologists (ACOG), the guidelines for the diagnosis of mild and severe preeclampsia are explained below.

You can compare and find the differences in the magnitude of the signs and the results of the pathological tests. Symptoms remain the same except that the severe form exhibits symptoms that are more intense in nature.

Similarly, the complications that result in the mother and those in the fetus are more likely to onset with the severe form of preeclampsia.

You may be diagnosed with mild preeclampsia if you have high blood pressure and proteinuria (high levels of protein in your urine).

Your preeclampsia will be severe if you have symptoms of mild preeclampsia along with kidney or liver damage, which will be detected in your liver function and kidney function blood tests.

What is preeclampsia?

Preeclampsia is the most common complication that can develop during your pregnancy. It should be addressed promptly because otherwise, a dangerous situation can arise from it for the mother and the fetus.

You, as a mother, can feel its presence from certain symptoms and signs. However, sometimes it develops but does not present any symptoms. It is then detected during your routine prenatal screening. Complications can be prevented if you take proper treatment.

Preeclampsia is a visitor that stays throughout your pregnancy and will go away only after your delivery. Treatment only aims to control its signs and symptoms.

Preeclampsia, if ignored, can herald the onset of eclampsia, a more serious disorder that can more likely be fatal for the baby and the mother. Eclampsia is characterized by albuminuria, hypertension, and convulsions. Every time the mother suffers a convulsion or seizure, the baby suffers a loss of oxygen supply, which can affect the development and brain of the baby.

Mild preeclampsia

Mild preeclampsia does not present any symptoms. It can be detected during medical examinations and lab tests screening. Blood pressure will be elevated and certain changes will be seen in your urine and blood tests

  • New onset blood pressure is 140 to 159 mm Hg systolic and/or 90 to 109 mm Hg diastolic
  • Proteinuria (protein in urine) is 300 mg/24 hours; or ≥1+ on 2 random urine samples, collected at least 4 hours apart, or
  • Protein: creatinine ratio is ≥0.3 mg/dL.

In the absence of proteinuria, the following factors could be present:

  • Thrombocytopenia with platelets count <100,000/uL
  • Serum creatinine ≥1.1 mg/L or a doubling of the serum creatinine concentration in the absence of another renal disease
  • Impaired liver function with elevated blood concentrations of liver transaminases to twice normal concentration.
  • Pulmonary edema
  • Cerebral or visual disturbances

Severe preeclampsia

In the severe form, the following differences will be seen:

  • BP is ≥160 mmHg systolic and/or ≥110 mm Hg diastolic on two occasions and taken at least six hours apart
  • Proteinuria is 300 mg/24 hours; or ≥1+ on 2 random urine samples, collected at least 4 hours apart
  • Protein: creatinine ratio is ≥0.3 mg/dL

In the absence of proteinuria, the following factors should be present:

  • Thrombocytopenia with platelets count <100,000/uL
  • Serum creatinine ≥1.1 mg/L or a doubling of the serum creatinine levels in the absence of another renal disease
  • Impaired liver function as indicated by elevated blood levels of liver transaminases to twice the normal concentration
  • Pulmonary edema
  • Cerebral or visual disturbances.

Complications such as eclampsia and HELLP syndrome are seen in severe forms of preeclampsia.

Postpartum depression after mild and severe preeclampsia

In a study conducted by the U.S. Library of Medicine National Institute of Health, among the cases of mild preeclampsia, 23% of the women reported postpartum depressive symptoms at some time up to 26 weeks after delivery while 44% of the women suffered from it after having suffered from severe preeclampsia. Women are otherwise prone to depression and can easily go into it when exposed to stress and anxiety-prone situations.

The study further concluded that it is not the magnitude of the condition but the consequences that seem to cause the depression. Such consequences include admission to the Neonatal Intensive Care Unit (NICU) and perinatal death

Women whose baby has died after admission to the NICU or for whatever reason are particularly at high risk of suffering from postpartum depression.

How do you classify early and late-onset preeclampsia?

The National Institute for Health and Care Excellence (NICE) has laid down certain criteria for classifying preeclampsia according to the timing of its onset.

  • Preeclampsia of early onset is that which comes on prior to 34 weeks. The earlier the onset, the more the risks of complications.
  • Mid-onset preeclampsia comes on after 34 weeks and prior to 37 weeks.
  • Late-onset preeclampsia is that which develops after 37 weeks.
  • Postpartum preeclampsia develops after delivery.