Pregnancy-induced hypertension without proteinuria: is it true preeclampsia?

A profile scoring system has recently been developed as a standardized method of early identification and severity assessment of pregnancy-induced hypertension (PIH). The purpose of this study is twofold: (1) to compare the PIH profile scores of patients demonstrating mild PIH without proteinuria with those of patients demonstrating mild PIH with proteinuria, and (2) to introduce the PIH profile graph as a standardized clinical assessment tool. Serial PIH profile data after 24 weeks' gestation from 46 term primigravid patients with mild PIH (group 1 = 19 patients without proteinuria; group 2 = 27 patients with proteinuria) were plotted on PIH profile graphs and compared. Profile scores from ten normotensive primigravidas at term served as controls. Serial profile scores for groups 1 and 2 showed similar patterns on the profile graph. Based on these data, we believe that PIH without proteinuria is clinically and biochemically a manifestation of true preeclampsia before the onset of proteinuria. Furthermore, the PIH profile graph allows one to identify subtle changes in the disorder and to anticipate the development of severe preeclampsia.