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Preeclampsia


Description

Preeclampsia,, which is also called toxemia of pregnancy, is a problem that occurs in some women during pregnancy. Preeclampsia is characterized by high blood pressure, fluid retention that first shows up in the second half of pregnancy, and protein in the urine.

Preeclampsia can range from mild to severe, and is treatable. Since preeclampsia can severely restrict the flow of blood to the placenta, it can be quite dangerous for a developing baby. If it's not treated it can develop into eclampsia, a serious condition that can cause convulsions. Eclampsia can be very dangerous for a mother and her unborn child.

Causes

The cause of preeclampsia remains unknown; however, placental dysfunction may initiate the systemic vasospasm, ischemia, and thrombosis that eventually damages maternal organs.

Other causes include: altered cardiovascular reactivity (current hypothesis); Increased capillary permeability; Widespread vasospasm; Microthrombi; Hypertension

Risk factors for preeclampsia include extremes of maternal age (Teenage, Females > 35 years old), primigravida, multiple gestations, molar pregnancy, preexisting HTN, diabetes mellitus (DM), renal disease, preexisting connective tissue disease, vascular disease, prior history of preeclampsia or eclampsia, and family history of preeclampsia or eclampsia; Lower socio-economic status; Collagen disorders; First subsequent pregnancy with a different father; Chronic hypertension.

Conventional Labs

Elevated BP (> 140/90 [18.6/12 kPa] or increased 30 [4 kPa] systolic or increased 15 [2 kPa] diastolic) recorded on 2 BP readings 6 hours apart

Rapid excessive weight gain (> 5 lb/week) (2.3 kg/week)

Proteinuria (> 300 mg/24 hrs or > 1 gram/L)

Uric acid increased (mild increase > 5.5 mg/dL [0.32 mmol/L]); (severe increase > 9.5 mg/dL [0.56 mmol/L])

Thrombocytopenia

CrCl < 90 mL/min/1.73m2 (0.87 mL/s/m2)

Increased BUN (> 16 mg/dL [5.7 mmol/L])

Increased creatinine (> 1.0 mg/dL [88 mol/L])

Abnormal increased liver function tests

Increased fibrin degradation products

Increased PT

Decreased fibrinogen

Urinalysis: Granular casts, Red blood cell casts, Renal tubular cell casts, White blood cell casts, Increased urine specific gravity

Increased T4

Thrombocytopenia

Decreased fibrinogen

Disseminated intravascular coagulation

Hyperbilirubinemia

 

 

 

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