Preeclampsia and Eclampsia


Epidemiology

Definitions

  • Preeclampsia: new onset of hypertension and proteinuria or hypertension and end-organ dysfunction with/without proteinuria after 20 was of gestation in a previously normotensive female
    • Preeclampsia May Also Develop Postpartum in Some Cases
  • Eclampsia: preeclampsia with seizures (without an alternative neurologic explanation for the seizures)

Demographics

  • Incidence: occurs in approximately 4.6% of pregnancies worldwide

Risk Factors

  • Advanced Maternal Age
  • First Pregnancy (Nulliparity)
  • History of Pre-Eclampsia/Eclampsia
  • Family History of Pre-Eclampsia/Eclampsia
  • Twin Pregnancy
  • Pre-Existing Medical Conditions


Diagnosis

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Clinical Manifestations

General Comments

Timing

Diagnostic Criteria for Preeclampsia (One of the Following) (Obstet Gynecol, 2013) [MEDLINE]

Cardiovascular Manifestations

Hypertension (see Hypertension)

Gastrointestinal Manifestations

Elevated Liver Function Tests (LFT’s) (see Elevated Liver Function Tests)

Epigastric Pain

Nausea/Vomiting (see Nausea and Vomiting)

Right Upper Quadrant (RUQ) Abdominal Pain (see Abdominal Pain)

Hematologic Manifestations

Hemoconcentration

Hemolytic Anemia (see Hemolytic Anemia)

Thrombocytopenia (see Thrombocytopenia)

Neurologic Manifestations

Headache (see Headache)

Hyperreflexia (see Hyperreflexia)

Ischemic Cerebrovascular Accident (CVA) (see Ischemic Cerebrovascular Accident)

Posterior Reversible Encephalopathy Syndrome (PRES) (see Posterior Reversible Encephalopathy Syndrome)

Seizures (see Seizures)

Visual Symptoms

Pulmonary Manifestions

Acute Respiratory Distress Syndrome (ARDS) (see Acute Respiratory Distress Syndrome)

Renal Manifestations

Acute Kidney Injury (AKI) (see Acute Kidney Injury)

Hyperuricemia (see Hyperuricemia)

Oliguria (see Oliguria)

Proteinuria (see Proteinuria)

Reproductive Manifestations

Abruptio Placentae (see Abruptio Placentae)

Rheumatologic Manifestations

Peripheral Edema (see Peripheral Edema)

Other Manifestations

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Treatment

Preeclampsia without Severe Features

Preterm Pregnancy <34 wks Gestation

Preterm Pregnancy 34-36 wks Gestation

Term Pregnancy

Preeclampsia with Severe Features

Criteria for Preeclampsia with Severe Features

Therapy


Prognosis

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References