All are the cardinal sign of Pre-eclampsia; EXCEPT:

Combined AIIMS - 2020 (Jodhpur, Bhopal, Patna, Raipur)

Obstetrics & Gynaecology

Easy

Appeared in: Combined AIIMS - 2020 (Jodhpur, Bhopal, Patna, Raipur)

Explanation

Weight loss is not a sign of pre-eclampsia; it is the opposite of what is expected.
Pre-eclampsia involves widespread endothelial dysfunction, leading to increased vascular permeability and fluid shifting from the intravascular to the interstitial space.
This fluid shift results in generalized edema and a corresponding rapid weight gain, not weight loss.
Therefore, weight loss is the correct answer as it is the exception among the cardinal and common signs of pre-eclampsia.

Option A: Proteinuria, or the presence of excess protein in the urine, is a key diagnostic criterion for pre-eclampsia, indicating kidney damage.
Option B: Increased blood pressure (hypertension) is the defining feature of pre-eclampsia, typically appearing after 20 weeks of gestation.
Option C: Edema (swelling) due to fluid retention is a very common sign in pre-eclampsia, although it is no longer a mandatory diagnostic criterion. Sudden, severe edema is particularly concerning.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Signs and symptoms of pre-eclampsia as background academic context rather than a clinical decision trigger.
Nurses must meticulously monitor pregnant women for signs of pre-eclampsia, including regular blood pressure checks, urine dipstick tests for protein, and assessing for edema, headaches, or visual changes.
Patient education is critical. The nurse should teach the patient to report any sudden weight gain, swelling, severe headaches, vision changes, or upper abdominal pain immediately.
What if? If a patient with mild pre-eclampsia suddenly develops a severe headache and visual disturbances, the nurse's priority action changes from routine monitoring to immediate escalation. This indicates progression to severe pre-eclampsia, requiring urgent intervention to prevent eclampsia (seizures) and other complications. The nurse should notify the provider immediately, prepare for potential administration of magnesium sulfate, and ensure emergency equipment is available.

How to Approach the Question

First, identify the core concept of the question, which is the 'cardinal signs of pre-eclampsia'.
Note the keyword 'EXCEPT'. This means you are looking for the option that is NOT a sign of pre-eclampsia.
Recall the pathophysiology of pre-eclampsia. It involves hypertension (increased blood pressure) and endothelial damage, which leads to protein leaking into the urine (proteinuria) and fluid leaking into tissues (edema and weight gain).
Evaluate each option against this knowledge:
Proteinuria: This is a classic, key sign.
Increased blood pressure: This is the defining sign.

Concept Tested & Keywords

Concept Tested: Signs and symptoms of pre-eclampsia
Stem keywords: cardinal sign, Pre-eclampsia
Lead-in keywords: EXCEPT
Negative lead-in flag: The question asks for the sign that is NOT associated with pre-eclampsia.

Q-LQF6-eYfMdqJLrMlExgV

E6 Medicine Harrison 22e Part 2 p. 1803-1805

E6 Obstetrics Williams p. 69-95