M.M.

COLLEGE OF
NURSING
ASSIGNMENT
ON
MILD, MODERATE AND SEVERE
PRE-ECLAMPSIA

SUBMITTED TO: SUBMITTED BY:

MRS SIMARJEET KAUR NADIYA RASHID

ASSISTANT PROFESSOR MSC NURSING II YEAR

OBG DEPARTMENT 1918721

 PREECLAMPSIA

DEFINITION: Preeclampsia formerly called toxemia, is when a pregnant woman has high blood
pressure, protein in her urine, and swelling in her legs, feet, and hands. It can range from mild to
severe. It usually happens late in pregnancy, though it can come earlier or just after delivery.

Preeclampsia can lead to eclampsia, a serious condition that can have health risks for mother and
baby and, in rare cases, cause death. Women with preeclampsia who have seizures have
eclampsia.

Calculation based on mean arterial pressure (MAP)

Systolic pressure + (diastolic pressure × 2) = MAP

The rise of blood pressure should be evident at least on two occasions at least 6 hours apart.
The level is arbitrary and is based on the observation, that complications are likely to be more
beyond this level. Diastolic blood pressure is noted at the point of disappearance of sounds
Blood pressure is measured on the right arm, with the patient lying on her side at 45° to the
horizontal. In the outpatient, sitting posture is preferred. In either case, the occluded brachial
artery should be kept at the level of the heart.
Preeclampsia Signs and Symptoms

In addition to swelling (also called edema), protein in the urine, and high blood pressure,
preeclampsia symptoms include:

 Weight gain over 1 or 2 days because of a large increase in bodily fluid

 Abdominal pain, especially in the upper right side
 Severe headache
 Change in reflexes
 oligourea
 Dizziness
 Severe vomiting and nausea
 Vision changes like flashing lights, floaters, or blurry vision

Edema: Demonstration of pitting edema over the ankles after 12 hours bed rest or rapid gain

in weight of more than 1 lb a week or more than 5 lb a month in the later months of pregnancy
may be the earliest evidence of pre-eclampsia. However, some amount of edema is common

(physiological) in a normal pregnancy.

Proteinuria: Presence of total protein in 24 hours urine of more than 0.3 gm or >2+ (1.0 gm/L)

on at least two random clean-catch urine samples tested > 4 hours apart in the absence of

urinary tract infection is considered significant.

Test for protein in urine by multiple reagent strip (dipstick) as follows: Trace = 0.1 gm/L;

1+ = 0.3 gm/L;

2+ = 1.0 gm/L; 3+ = 3.0 gm/L; 4+ = 10.0 gm/L.

Degree of Pre-Eclampsia

There are three degrees of preeclampsia.

1. Mild (mild preeclampsia) - is characterized by increased pressure of not higher than 150
/90mm Hg. , proteinuria up to 1 g / l. There is edema of the lower extremities. The platelet count

in the blood at least 140h109 / L, creatinine - 100 micromolar.

2. Moderate degree of pre-eclampsia - there is an increase in blood pressure up to 170/110 mm

Hg. , urine protein over 5g / L, platelet count ranges from 150 to 180h109 / l, creatinine

from 100 to 300 mmol / l.

3. Severe pre-eclampsia - characterized by an increase in pressure above 170/110 mm Hg. , a

protein in the urine exceeds the mark of 5g / L, creatinine 300 umol / L. A headache in the back

of the head and forehead, the violation of which is shown flashing flies, the pain in his right

side due to the swelling of the liver. Severe pre-eclampsia can go into eclampsia - one of the

most dangerous forms of preeclampsia, which is characterized by seizures. Severe pre-eclampsia

and eclampsia is a disease that can pose a threat to the health and life of the mother and child.
 Difference between mild, moderate and severe pre- eclampsia

Criteria Mild pre-eclampsia Moderate pre-eclampsia Severe pre-eclampsia

Blood Pressure not higher than 150 / up to 170/110 mm Hg above 170/110 mm Hg
90mm Hg
Symptoms Absent Present Present
Proteinuria up to 1 g / l. From to 1 g / l to 5g / L exceeds the mark of 5g /L
Liver and renal Absent Normal Abnormal
function
Platelet conut Normal Normal Normal Thrombocytopenia
Pulmonary Absent present Present
count
Convulsion Absent Present present
Hellp Syndrome absent absent Present
Fetal growth Absent absent present
restriction