Which feature indicates the presence of severe features in preeclampsia?

The presence of severe features in preeclampsia is primarily indicated by specific clinical and laboratory findings that signify organ dysfunction or severe hypertension. In this context, renal insufficiency with elevated serum creatinine levels is a recognized marker of severe preeclampsia. A creatinine level of 1.1 mg/dL, although it may not seem significantly elevated in all contexts, is part of the threshold that triggers concern for potential worsening.

The criteria for severe preeclampsia include severe hypertension (typically defined as blood pressure equal to or exceeding 160/110 mmHg), the presence of renal insufficiency (usually indicated by creatinine levels greater than 1.1 mg/dL), elevated liver enzymes, neurological symptoms (such as severe headaches or visual disturbances), pulmonary edema, and fetal growth restriction.

In contrast, normal blood pressure under 140/90 mmHg does not align with the definition of severe preeclampsia, and the presence of general malaise without additional symptoms lacks the specificity needed to indicate severe features. Furthermore, while fetal growth restriction can be associated with preeclampsia, it is not, by itself, a standalone indicator of severe disease.

Thus, the correct answer underscores the essential criterion of