What is an early sign of preeclampsia?

• A. Severe headache + vision changes
• B. Epigastric pain
• C. Hyperreflexia
• D. Massive proteinuria

Answer: (C)

Hyperreflexia reflects CNS irritability from rising blood pressure and cerebral involvement that can occur early in preeclampsia. Abnormal placentation leads to endothelial dysfunction and vasospasm, which can cause cerebral edema and heightened reflexes even before headaches or visual changes develop. While severe headache and vision changes indicate more advanced disease, and epigastric ( RUQ ) pain points to hepatic involvement in severe cases, proteinuria is not reliably an early marker—some patients have little or no protein in the urine early on. So brisk or hyperactive reflexes are among the first signs clinicians look for as preeclampsia begins to manifest.