Preeclampsia

Pathophysiology
Causes/Risk Factors
-Age younger than 20
older than 40
-First pregnancy
-Morbid Obesity
-Multifetal Gestation
-Chronic renal disease
-Chronic hypertension
-Family history of
preeclampsia or previous
history
-Diabetes Mellitus
-RH Incompatibility
-Molar pregnancy

Diagnostic Tests
-HELLP syndromeHemolysis, elevated liver
enzymes, low platelets
-Increased Creatinine,
Uric Acid, Liver enzymes,
& Bilirubin
-Decreased Hgb &
platelets

Treatment
Antihypertensives,
anticonvulsants
(magnesium sulfate), avoid
sodium and caffeine,
increase fluids, bed rest,
delivery of baby.

Disruptions in placental
perfusion and endothelial cell
dysfunction. Vascular
remodeling not fully developed
causing decreased placental
perfusion and hypoxia.
Placental ischemia releases a
substance that is toxic to
endothelial cells. This causes
poor tissue perfusion to all
organ systems, increased
peripheral resistance, increased
BP, increased endothelial cell
permeability which causes
protein and fluid loss.
Deceased kidney perfusion
leads to albumin lost in urine,
increased uric acid levels,
sodium and water being
retained, possibly leading to
acute tubular necrosis and renal
failure. Plasma colloid osmotic
pressure decreases.
Intravascular volume is reduced
causing hemoconcentration,
increased blood viscosity, and
edema. Decreased liver
perfusion causes increased liver
enzymes, hepatic edema, and
possibly subcapsular
hemorrhage. Arteriolar
vasospasms and decreased
blood flow can cause visual
blurring and blind spots.
Cerebral edema and

Clinical Manifestations
-Hypertension
-Proteinuria
-Edema
-Ankle Clonus/ Hyperreflexes
-Headaches
-Nausea/ Vomiting
-Blurred vision/Flashes of
light
-Dyspnea
-Seizures

Possible Complications
-Progression to eclampsia
(increased seizures &
coma)
-HEELP syndrome
-Acute renal failure/ Liver
failure
-Respiratory Distress
syndrome
-DIC
-Cerebral hemorrhage

Complications for Baby

-Growth restriction
-Placental abruption
-Degenerative aging of
placenta
-Lack of blood flow to
placenta
-Mortality

References:
Lowdermilk, D.L., Perry, S.E., Cashion, K. (2014). Pregnancy at risk: gestational conditions. In Maternity nursing. 8th ed. Elsevier. Maryland
Heights, MO.
Sommer, S., Johnson, J., Roberts, K., Redding, S., Churchill, L., Elkins, C., & Roland, P. (2013). Medical conditions. In RN maternal newborn
nursing. 9th ed. Stilwell, KS:
Assessment Technologies Institute, LLC.