Preeclampsia and Eclampsia

Preeclampsia is a complication of pregnancy characterized by hypertension, edema, and proteinuria. The diagnosis of eclampsia is made once seizures begin. The disease does not occur until after the twentieth week of gestation, except with hydatidiform mole. Some patients will not know (or admit) that they are or may be pregnant. Those without adequate prenatal care may not know the gestational age. Approximately 14% of cases occur in the postpartum period (25% of these in the 2- to 14 day range). HELLP syndrome (hemolysis, elevated liver function tests, and low platelets) occurs in up to 10% of cases of severe preeclampsia and carries a high risk of disseminated intravascular coagulation (DlC) (30%).

Causes

• Preeclampsia and Eclampsia may be cause by poor nutrition, high body fat or insufficient blood flow to the uterus.
• Preeclampsia may be caused by a shallowly implanted placenta which becomes hypoxic, leading to upregulated inflammatory mediators secreted by the placenta and acting on the vascular endothelium. If Preeclampsia severe, then it may lead to fulminant preeclampsia, with headaches, visual disturbances, and epigastric pain, and further to HELLP syndrome and eclampsia.
• Eclampsia may also cause if you have high blood pressure, weight gain, and protein in the urine.

Symptoms

• Swelling of the hands, face, legs
• Abdominal pain (especially epigastric and right upper quadrant)
• Headache
• Visual disturbances
• Altered mental status
• Seizures may be among presenting complaints and is required for the diagnosis of eclampsia

Signs

• Hypertension is diagnosed at much lower pressures than in other situations. Blood pressure of 140/90, or an increase of 30/l5 from baseline, is abnormal. Treatment is required for blood pressure 160/110 or higher.
• Edema, although isolated leg edema may be normal.
• Altered mental status
• Hyperreflexia
• Petechiae
• Bruising

Treatment

Various treatment, that are used to treat Preeclampsia and Eclampsia may include:

• Magnesium can be injected into the veins to prevent eclampsia-related seizures.
• Hydralazine or another antihypertensive drug used to treat high blood pressure.
• Monitoring fluid intake.
• Another treatment, in which treatment includes may be limited to bed rest, with careful daily monitoring of weight, blood pressure, and urine protein via dipstick. This careful monitoring will be required throughout pregnancy, labor, delivery.