Pregnancy Complications: Preeclampsia and Eclampsia

Definition and Pathophysiology

• Preeclampsia: a pregnancy complication characterized by high blood pressure and damage to organs such as the liver, kidneys, and brain
• Eclampsia: a severe complication of preeclampsia, characterized by seizures or coma

Risk Factors

• Nulliparity
• Age >35 years
• Multiple gestations
• History of hypertension, diabetes, or kidney disease
• Family history of preeclampsia
• Obesity
• Pre-existing medical conditions (e.g. lupus, thrombophilia)

Signs and Symptoms

• High blood pressure (>140/90 mmHg)
• Proteinuria (excess protein in urine)
• Vision changes (e.g. blurred vision, double vision)
• Abdominal pain (especially in the upper right quadrant)
• Nausea and vomiting
• Headache
• Fatigue
• Seizures or coma (in eclampsia)

Diagnosis

• Blood pressure measurement
• Urinalysis for proteinuria
• Blood tests for liver and kidney function
• Platelet count and clotting studies
• Fetal monitoring (e.g. non-stress test, biophysical profile)

Management and Treatment

• Bed rest
• Medications to control blood pressure and seizures
• Corticosteroids to promote fetal lung maturity
• Antenatal corticosteroids to reduce neonatal respiratory distress
• Induction of labor or cesarean section (depending on gestational age and fetal well-being)
• Delivery as soon as possible if eclampsia occurs

Complications

• Maternal: stroke, kidney failure, pulmonary edema, cardiac arrest
• Fetal: growth restriction, prematurity, stillbirth
• Neonatal: respiratory distress, intraventricular hemorrhage, hypoglycemia

Definition and Pathophysiology

• Preeclampsia is a pregnancy complication characterized by high blood pressure and damage to organs such as the liver, kidneys, and brain.
• Eclampsia is a severe complication of preeclampsia, characterized by seizures or coma.

Risk Factors

• Women who are nulliparous (never given birth before) are at risk.
• Women over 35 years old are at risk.
• Multiple gestations increase the risk.
• A history of hypertension, diabetes, or kidney disease increases the risk.
• A family history of preeclampsia is a risk factor.
• Obesity increases the risk.
• Pre-existing medical conditions, such as lupus or thrombophilia, increase the risk.

Signs and Symptoms

• Blood pressure greater than 140/90 mmHg is a sign of preeclampsia.
• Proteinuria (excess protein in urine) is a sign of preeclampsia.
• Vision changes, such as blurred vision or double vision, are symptoms.
• Abdominal pain, especially in the upper right quadrant, is a symptom.
• Nausea and vomiting are symptoms.
• Headache is a symptom.
• Fatigue is a symptom.
• Seizures or coma are symptoms of eclampsia.

Diagnosis

• Blood pressure measurement is used to diagnose preeclampsia.
• Urinalysis is used to detect proteinuria.
• Blood tests are used to assess liver and kidney function.
• Platelet count and clotting studies are used to assess blood clotting.
• Fetal monitoring, such as non-stress tests and biophysical profiles, are used to assess fetal well-being.

Management and Treatment

• Bed rest is used to manage preeclampsia.
• Medications are used to control blood pressure and seizures.
• Corticosteroids are used to promote fetal lung maturity.
• Antenatal corticosteroids are used to reduce neonatal respiratory distress.
• Induction of labor or cesarean section may be necessary, depending on gestational age and fetal well-being.
• Delivery is necessary as soon as possible if eclampsia occurs.

Complications

• Maternal complications include stroke, kidney failure, pulmonary edema, and cardiac arrest.
• Fetal complications include growth restriction, prematurity, and stillbirth.
• Neonatal complications include respiratory distress, intraventricular hemorrhage, and hypoglycemia.