Preeclampsia is best described as a multi-system disorder characterized by which combination of findings?

• A. Chronic hypertension without proteinuria
• B. New onset hypertension with proteinuria or end-organ dysfunction
• C. Hypotension with edema only
• D. Gestational diabetes with hypertension

Answer: (B)

Preeclampsia is a pregnancy-specific disorder defined by the emergence of high blood pressure after mid-pregnancy (typically after 20 weeks) together with evidence of organ involvement. The hallmark is that the hypertension is new, and it appears alongside either protein leakage in the urine or dysfunction in other organ systems, reflecting widespread endothelial disturbance.

Proteinuria shows the kidneys are affected by the condition, but preeclampsia can also be diagnosed if there is end-organ dysfunction alone—such as elevated liver enzymes, renal impairment, low platelets, cerebral or visual symptoms, or pulmonary edema—even without proteinuria. This multi-system impact is what makes preeclampsia more than just high blood pressure.

Why the other descriptions don’t fit as well: having chronic hypertension without new onset proteinuria or organ dysfunction isn’t preeclampsia because the hypertension is preexisting. Hypotension with edema doesn’t capture the hypertensive aspect or the systemic involvement. Gestational diabetes with hypertension describes metabolic and vascular issues separately from the defining proteinuria or end-organ findings of preeclampsia.

So the best description is new-onset hypertension after 20 weeks with either proteinuria or evidence of end-organ dysfunction.