Introduction
Preeclampsia is defined as hypertention of at least 140/90 mmHg recorded on two separate occasions, at least 4 hours apart and in the presence of at least 300 mg protein in a 24 hours collection of urine.Risk factors:
• previous severe and early onset preeclampsia
• Extremes age { >40 or <18 )
• Family history
• Obesity
• primiparity
• Multiple pregnancy
• long birth interval ( >10 years)
• pre-existing medical conditions
• Hypertension, Renal disease, Diabetes, Antiphospholipid antibodies
Signs and symptoms
Organ- specific changes
Cardiovascular system:
• Generalized vasospasm
• Increased peripheral resistance
• Reduced central venous pressure
Hematological changes
• platelet activation and depletion
• coagulopathy
• Decreased plasma volume
• Increased blood viscosity
Renal changes
• proteinuria
• Decreased Glomerular filtration rate
• Decreased urate excretion
Liver changes
• periportal necrosis
CNS
• Cerebral edema
• Cerebral hemorrhage
Investigations
Pre-eclampsia is a condition that can develop in pregnant women before their baby's birth. It's a serious complication that can cause birth defects, and can be fatal to both mother and baby.
There are many investigations that can be done to try and determine the cause of pre-eclampsia. These investigations can include:
•blood tests
•scansand tests to look at the mother's blood pressure and heart rate.
•Urinalysis by dipstick
•24-hour urine collection
•Coagulation profile
•plasma urate concerntration
•Liver function.
It's important to get the correct diagnosis as soon as possible, so that the mother and baby can receive the best possible care.
Treatment
Preeclampsia is a potentially life-threatening disorder that usually develops in pregnant women between the 15th and 24th week of pregnancy. It is characterized by high blood pressure, protein in the urine, and swelling of the hands, feet, and abdomen. There is no known cure for preeclampsia, but treatment focuses on reducing the risk of the disorder and managing its symptoms.
Treatment for preeclampsia typically involves addressing the underlying causes, such as high blood pressure, diabetes, and obesity. Medications may be prescribed to lower blood pressure and reduce the risk of stroke, heart attack, and other complications.
Some of the medications that are used to treat preeclampsia include: magnesium sulfate, angiotensin converting enzyme inhibitors (ACE inhibitors), and beta blockers. Despite the
Complications
Complications of preeclampsia may include:
1. Preterm birth
2. Low birth weight
3. Neonatal jaundice
4. Respiratory distress
5. Seizures
6. Brain damage
7. Birth defects
8. Preterm labor
9. Preeclampsia-related death
Preterm birth is the most common complication of preeclampsia. Preterm birth is defined as delivery before 37 weeks of pregnancy, which can lead to serious health problems for the baby, including increased rates of illness and death.
Low birth weight is also a common complication of preeclampsia
Prevention
Preeclampsia is a condition that can develop during early pregnancy and can be life-threatening. Preeclampsia is a combination of high blood pressure, protein in the urine, and swelling of the feet and hands. There are many things you can do to prevent preeclampsia from happening, including: •getting regular physical exams,
•eating a balanced diet,
•getting regular exercise,
•and avoiding alcohol and tobacco.
If you are pregnant and experience any of the following symptoms, see your doctor immediately: severe headache, vision problems, intense swelling of the feet or hands, chest pain, shortness of breath, or trouble breathing.
Eclampsia
Eclampsia is defined as mal convulsions occuring in a women with established preeclampsia, in the absence of any other neurological or metabolic cause.
It is a serious complication of pregnancy that can be life-threatening.
This can lead to a range of serious symptoms, including seizures, high blood pressure, and a rapid and uncontrolled rise in body temperature. If left untreated, eclampsia can lead to serious health complications, including seizures, coma, and even death.
Management
• Request for assistance - experienced medical professionals in the fields of obstetrics and anesthesia.• Maintain airway, breathing, and circulation
• maintain IV line
Antihypertensive drugs:
• Hydralazine given intravenously causes a direct relaxation of the smooth muscle in the arterioles.
• Labetalol: Alpha- and beta-blocker
Anticonvulsant drugs:
•MgSO4 is the drug of choice
• It widens blood vessels in the brain and stabilizes cell membranes.
• An initial injection of 5 grams can be given intravenously to stop seizures, followed by a continuous infusion at a rate of 2 grams per hour for ongoing management.
Risks of preeclampsia & eclampsia to the mother
Preeclampsia and eclampsia are serious medical conditions that can occur during pregnancy and can be life-threatening for both the mother and the baby.
Preeclampsia is a condition characterized by high blood pressure and protein in the urine that occurs after the 20th week of pregnancy. If left untreated, it can lead to eclampsia, which is a more severe form of the condition that can cause seizures or convulsions. Both preeclampsia and eclampsia can cause significant harm to the mother.
The risks of preeclampsia and eclampsia to the mother include:
•Seizures: Eclampsia can cause seizures, which can be life-threatening for the mother and can lead to complications such as brain damage, respiratory distress, and cardiac arrest.
•Organ damage: Preeclampsia and eclampsia can damage vital organs such as the liver, kidneys, and brain. This can lead to serious complications such as liver failure, kidney failure, and stroke.
•Blood clotting disorders: Preeclampsia and eclampsia can cause blood clotting disorders such as disseminated intravascular coagulation (DIC). This can cause excessive bleeding, leading to hemorrhage and shock.
•Preterm delivery: In severe cases, preeclampsia and eclampsia may require early delivery of the baby, which can lead to complications such as respiratory distress syndrome, infections, and developmental problems.
•Maternal death: In rare cases, preeclampsia and eclampsia can be fatal for the mother.
It is essential for pregnant women to receive regular prenatal care and monitoring to detect and manage these conditions early. If you experience any symptoms such as swelling, high blood pressure, or changes in vision, contact your healthcare provider immediately.
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