In 2013, ACOG has decided to remove proteinuria from the definition of severity of<unk>  but it is still part of the diagnosis
Diagnosis is either based on blood pressure AND proteinuria or the presence of Severe Symptoms
Systolic ≥140 mmHg or diastolic ≥90 mmHg on 2 occasions at least 4 hours apart, after 20 weeks gestation with previously normal BPs
Systolic ≥160 mmHg or diastolic ≥110 mmHg acutely requiring emergent blood pressure decreases
Proteinuria ≥300mg in a 24-hour urine collection
Spot protein(mg/dL)/creatinine(mg/dL) ratio ≥0.3
1+ on urine dipstick (if no quantitative measurement is unavailable)
In the absence of proteinuria, new onset hypertension with any severe features:
Systolic BP ≥160 or diastolic BP ≥110, 2 occasions, 4 hours apart, while on bed rest (unless antihypertension meds were started before this time)
Thrombocytopenia platelets <100,000/mL
Elevated LFTS (2x normal concentration), severe<unk> rsistent RUQ/epigastric pain unresponsive to medications and no alternative diagnosis
Progressive renal insufficiency (creatinine >1.1mg/dL or doubling of creatinine concentration in absence of renal disease)
Reduced urine output < 30 cc/hr may indicate severe disease
Pulmonary edema
New onset cerebral or visual disturbance (scotomata, blurry vision, loss of vision)
Reduced urine output < 30 cc/hr may indicate severe disease
Preeclampsia
Amniotic fluid embolus
Eclampsia
Chorioamnionitis
Comorbid diseases in pregnancy
Acute fatty liver of pregnancy
HELLP syndrome
Postpartum hemorrhage