Preeclampsia with severe features may cause organ damage; these features may include Severe headache Visual disturbances Confusion Hyperreflexia Epigastric or right upper quadrant abdominal pain (reflecting hepatic ischemia or capsular distention) Nausea and / or vomiting Dyspnea (reflecting pulmonary edema, acute respiratory distress syndrome [ARDS], or cardiac dysfunction secondary to increased afterload) Oliguria (reflecting decreased plasma volume or ischemic acute tubular necrosis) Stroke (rarely) Diagnosis of Preeclampsia and Eclampsia Preeclampsia: New onset after 20 weeks gestation of hypertension (blood pressure [BP] ≥ 140/90 mm Hg) plus new unexplained proteinuria (> 300 mg/24 hours or a urine protein / creatinine ratio of ≥ 0.3) and / or signs of end-organ damage (1) BP criteria for preeclampsia are one of the following: Systolic BP ≥ 140 mm Hg and / or diastolic BP ≥ 90 mm Hg (at least 2 measurements taken at least 4 hours apart) Systolic BP ≥ 160 mm Hg and / or diastolic BP ≥ 110 mm Hg (at least 1 measurement) Proteinuria is defined as > 300 mg/24 hours.