Table 3.

Phenotype similarities and distinguishers between normal pregnancy, preeclampsia/HELLP, and kidney disease presenting in pregnancy

FeaturesNormal PregnancyPreeclampsia/HELLPLupus NephritisAtypical HUS
GestationAll>20 wkAnyTypically peri-/postpartum
Skin changes/rash++
Hair loss++
Edema+++++
Hypertension (BP>140/90 mm Hg)++++
UPCR≥0.3 mg/mg (>30 mg/mmol)+++
HematuriaTrace+–/+
Anemia+++–/+
Thrombocytopenia (<100×109/L)++++
Hemolysis+ Improves 48–72 h postdeliveryRare++ Persists >72 h after delivery
Serum creatinine⇓ in T1, ⇓⇓ in T2, ⇑ in T3⇑⇑
TransaminitisNoYesNoNo
ESR
dsDNA
ComplementCan ⇑⇓ (within normal range)⇓ in 30%−50%
  • HELLP, hemolysis, elevated liver enzymes, and low platelet count; HUS, haemolytic uraemic syndrome; +, part of phenotype; —, not part of phenotype; ++, common or substantially altered in phenotype; UPCR, urinary protein-to-creatinine ratio; –/+, occasionally seen in phenotype; ⇑, increase; T1, first trimester; ⇓, decrease; T3, third trimester; ⇑⇑, substantial increase; ESR, erythrocyte sedimentation rate; dsDNA, double-strand DNA.