North American Registry of Midwives (NARM) Practice Exam

What does a pitting edema of +2 represent in relation to preeclampsia?

1. Normal condition

2. Minor edema

3. Significant condition

4. Severe dehydration

The correct answer is: Significant condition

A pitting edema of +2 indicates a moderate degree of swelling that is significant enough to warrant attention, particularly in the context of preeclampsia. In this grading system, pitting edema is assessed on a scale from +1 to +4, with +1 being mild and +4 indicating severe edema whereby the indentation created by pressing on the swollen area takes longer to rebound. In the case of preeclampsia, which is characterized by high blood pressure and signs of damage to another organ system, commonly the kidneys, the presence of pitting edema can be a critical factor in monitoring the condition. A +2 rating suggests that there is a noteworthy accumulation of interstitial fluid that could signal increased vascular permeability or fluid overload, both of which are concerning indicators in patients with preeclampsia. This level of edema is typically not normal and should be viewed in context with other clinical signs, such as hypertension and proteinuria, which can indicate the progression of the disease. Therefore, recognizing a +2 pitting edema is essential for health care providers to assess the severity of a patient's condition and decide on the appropriate monitoring and intervention strategies.