Investigations for evidence of end-organ dysfunction - McMaster Textbook of Internal Medicine

Table 15.3-10. Investigations for evidence of end-organ dysfunction
Diagnostic test	Red flags
CBC	Anemia if hemolysis is present, thrombocytopenia
AST, ALT	Elevation of transaminases can occur in both preeclampsia and other causes of HELLP syndrome
Creatinine, uric acid	Baseline creatinine values in pregnancy are decreased. Elevations may be reported as “normal”; therefore, it is helpful to have a prepregnancy/early pregnancy value
LDH, bilirubin	Elevated if hemolysis is present
INR	Any increase suggests coagulation factor deficit. INR >1.3 suggests serious liver disease (consider acute fatty liver of pregnancy)
Placental growth factor	Not currently available in Canada
Midstream urine	Evidence of proteinuria or hematuria
Urine PCR or 24-h urine collection for protein	24-h urine >0.3 g/d or PCR >30 mg/mmol
ECG, chest radiography, troponin	Warranted if chest pain, shortness of breath, or other clinical signs suggestive of ischemia, edema, or ventricular depression are present. Consider in the case of a first presentation of hypertension to investigate for evidence of chronicity or underlying structural heart disease
Fetal and uterine artery ultrasonography	Fetal growth restriction, abnormal heart rate, stillbirth; abnormal uterine artery flow
ALT, alanine aminotransferase; AST, aspartate aminotransferase; CBC, complete blood count; ECG, electrocardiography; HELLP, hemolysis, elevated liver enzymes, low platelets; INR, international normalized ratio; LDH, lactate dehydrogenase; PCR, protein-to-creatinine ratio.