Why is proteinuria no longer required to diagnose preeclampsia?

The rationale behind the option stating that preeclampsia may exist without significant proteinuria is based on a deeper understanding of the condition and its symptoms. Historically, proteinuria was considered a hallmark symptom of preeclampsia, but recent research has shown that preeclampsia can occur in the absence of significant protein in the urine.

Preeclampsia is primarily characterized by hypertension and can also involve signs of end-organ dysfunction, not just proteinuria. Evidence has indicated that some women with preeclampsia may have normal levels of proteins in their urine at the time of diagnosis. Therefore, it is crucial to recognize that the presence of high blood pressure combined with other symptoms such as elevated liver enzymes, low platelet count, or signs of renal impairment can be sufficient for a diagnosis of preeclampsia, even if proteinuria is not present.

This new understanding reflects an evolution in the diagnostic criteria, aimed at identifying and treating preeclampsia more effectively, thus improving outcomes for both the mother and the fetus.