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Preeclampsia

Preeclampsia

Definition

Preeclampsia is high blood pressure and protein in the urine that develops after the 20th week of pregnancy.

Alternative Names

Toxemia; Pregnancy-induced hypertension

Causes, incidence, and risk factors

The exact cause of preeclampsia is not known. Possible causes include:

Preeclampsia occurs in a small percentage of pregnancies. Risk factors include:

Symptoms

Symptoms of preeclampsia can include:

  • Headaches
  • Swelling of the hands and face (edema)
  • Weight gain
    • More than 2 pounds per week
    • Sudden weight gain over 1 - 2 days

Note: Some swelling of the feet and ankles is considered normal with pregnancy.

Other symptoms that can occur with this disease:

  • Abdominal pain
  • Agitation
  • Decreased urine output
  • Nausea and vomiting
  • Vision changes

Signs and tests

  • Increase in blood pressure
  • Higher than normal liver enzymes
  • Platelet count less than 100,000 (thrombocytopenia)
  • Protein in the urine (proteinuria)
  • Swelling in the upper body
  • Weight gain

Treatment

The only way to cure preeclampsia is to deliver the baby. However, if that delivery would be very early (premature), the disease can be managed by bed rest, close monitoring, and delivery as soon as the fetus has a good chance of surviving outside the womb. Sometimes, medicines are prescribed to lower the mother's blood pressure.

The pregnant mother is usually admitted to the hospital, but some women may be allowed to stay at home with careful monitoring of their blood pressure, urine, and weight, and the baby.

Ideally, the condition is managed until the baby can be delivered after the 37th week of pregnancy.

Labor may be induced if any of the following occur:

  • Abdominal pain
  • Abnormal biophysical profile (a test to monitor the health of the fetus)
  • Abnormal liver function tests
  • Diastolic blood pressure greater than 100 mmHg consistently for a 24-hour period, or any confirmed reading over 110 mmHg
  • Eclampsia
  • Failure of the fetus to grow
  • Fluid in lungs (pulmonary edema)
  • HELLP syndrome
  • Increase in the level of creatinine in the blood
  • Low platelet count (thrombocytopenia)
  • Low urine production or severe protein in the urine, suggesting decline in kidney function
  • Persistent or severe headache

Delivery is the treatment o

...

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