Preeclampsia Introduction

Preeclampsia is a serious pregnancy complication characterized by high blood pressure and signs of damage to other organ systems, most commonly the liver and kidneys. It typically occurs after 20 weeks of pregnancy and can lead to serious complications for both the mother and the baby if left untreated.

Preeclampsia is believed to be caused by problems with the placenta, which may not be delivering enough blood to the baby. Risk factors for developing preeclampsia include a history of high blood pressure, obesity, diabetes, and certain medical conditions such as lupus or kidney disease.

Symptoms of preeclampsia can include high blood pressure, swelling in the hands and face, headaches, vision changes, and abdominal pain. If left untreated, preeclampsia can lead to complications such as seizures (eclampsia), stroke, organ damage, and even death for both the mother and the baby.

Treatment for preeclampsia typically involves close monitoring of blood pressure and other symptoms, bed rest, and sometimes medication to lower blood pressure. In severe cases, early delivery of the baby may be necessary to prevent further complications.

It is important for pregnant women to attend all prenatal appointments and report any symptoms of preeclampsia to their healthcare provider promptly. Early detection and management of preeclampsia can help reduce the risk of complications and ensure the best possible outcome for both mother and baby.

Preeclampsia

Definition:

Preeclampsia is a pregnancy-specific hypertensive disorder characterized by:

- High blood pressure (systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥90 mmHg)
- Proteinuria (protein in the urine)

Epidemiology:

- Affects 3-8% of pregnancies
- More common in first-time pregnancies and pregnancies with multiple fetuses

Risk Factors:

- Primiparity (first pregnancy)
- Multiple gestation
- History of preeclampsia or hypertensive disorders
- Obesity
- Advanced maternal age (>40 years)
- Pre-existing medical conditions: chronic hypertension, diabetes, kidney disease

Pathophysiology:

- Exact cause is unknown
- Involves abnormal placentation, leading to:
- Vasospasm
- Endothelial dysfunction
- Reduced blood flow to the uterus and fetus

Clinical Manifestations:

- Hypertension (usually develops after 20 weeks of gestation)
- Proteinuria
- Edema (swelling) in the hands, face, and legs
- Other symptoms may include:
- Headaches
- Visual disturbances
- Abdominal pain
- Nausea and vomiting

Complications:

- Maternal:
- Eclampsia (seizures)
- HELLP syndrome (hemolysis, elevated liver enzymes, low platelets)
- Stroke
- Kidney failure
- Liver failure
- Fetal:
- Intrauterine growth restriction
- Preterm birth
- Fetal death

Diagnosis:

- Based on clinical symptoms and laboratory findings (blood pressure and urine protein levels)

Treatment:

- Immediate:
- Magnesium sulfate to prevent eclampsia
- Antihypertensive medications to lower blood pressure
- Long-term:
- Bed rest
- Medication to control blood pressure and proteinuria
- Preterm delivery if severe complications develop

Prevention:

- No definitive preventive measures
- Early prenatal care and management of risk factors (e.g., controlling blood pressure in women with pre-existing hypertension) may help reduce risk