What is one of the severe features that exclude the need for proteinuria in diagnosing preeclampsia?

The presence of pulmonary edema is recognized as one of the severe features that can lead to a diagnosis of preeclampsia without the requirement of proteinuria. In the context of preeclampsia, severe features indicate a higher risk for complications and warrant immediate evaluation and management. Pulmonary edema specifically suggests significant cardiovascular strain and fluid overload, which are potential consequences of severe hypertension and compromised organ function that can arise in this condition.

When diagnosing preeclampsia, the presence of severe features allows healthcare providers to initiate treatment and monitor the pregnancy closely, even in the absence of proteinuria. This is critical because it indicates escalating disease severity, which may necessitate urgent delivery or other interventions to protect both maternal and fetal health.

In contrast, fetal distress, increased uric acid, and elevated AST levels, while they may indicate various complications or conditions related to pregnancy, do not serve as diagnostic criteria for preeclampsia when proteinuria is absent. These features might suggest other underlying issues but are not definitive markers for diagnosing the condition. Thus, pulmonary edema stands out as a key indicator that reinforces the need for active management in the presence of severe preeclamptic symptoms.