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    Preeclampsia without severe features is defined as sustained high blood pressure after 20 weeks of pregnancy without pre-existing hypertension. It is caused by inadequate blood flow from the mother to the placenta due to abnormal remodeling of the arteries in the uterus. Risk factors include prior preeclampsia, multifetal gestation, obesity, and family history. Symptoms include excess weight gain, swelling, and fluid retention. Management involves delivery after 37 weeks or conservative management before then if the mother and baby are stable, with control of blood pressure but no other medications.

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    Preeclampsia without severe features is defined as sustained high blood pressure after 20 weeks of pregnancy without pre-existing hypertension. It is caused by inadequate blood flow from the mother to the placenta due to abnormal remodeling of the arteries in the uterus. Risk factors include prior preeclampsia, multifetal gestation, obesity, and family history. Symptoms include excess weight gain, swelling, and fluid retention. Management involves delivery after 37 weeks or conservative management before then if the mother and baby are stable, with control of blood pressure but no other medications.

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    6 views7 pages

    Pre-Eclampsia Knowledge

    Uploaded by

    jj
    Preeclampsia without severe features is defined as sustained high blood pressure after 20 weeks of pregnancy without pre-existing hypertension. It is caused by inadequate blood flow from the mother to the placenta due to abnormal remodeling of the arteries in the uterus. Risk factors include prior preeclampsia, multifetal gestation, obesity, and family history. Symptoms include excess weight gain, swelling, and fluid retention. Management involves delivery after 37 weeks or conservative management before then if the mother and baby are stable, with control of blood pressure but no other medications.

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    PRE-ECLAMPSIA WITHOUT SEVERE FEATURES

    DEFINITION:
    Preeclampsia is sustained BP elevation in pregnancy after 20 weeks’
    gestation in the absence of preexisting hypertension. (>140/90 mm Hg)
    PATHOPHYSIOLOGY:

    Inadequate uteroplacental perfusion leading Pathophysiology involves diffuse


    to placental ischemia, appears to be central vasospasm caused by :
    to the development of the disease. Deficient ● Loss of the normal pregnancy-
    remodeling of the spiral arteries. related refractoriness to vasoactive
    substances such as angiotensin .
    ● Relative or absolute changes in the
    following prostaglandin substances:
    ○ Increases in the vasoconstrictor
    thromboxane .
    ○ Decreases in the potent vasodilator
    prostacyclin.
    RISK FACTORS:

    High risk factors: Moderate risk factors:

    ● History of preeclampsia ● Nulliparity


    ● Multifetal gestation ● Obesity (body mass index > 30)
    ● Chronic hypertension ● Family history of preeclampsia
    ● Pregestational type 1 or 2 diabetes ● Age 35 years or older
    ● Kidney disease ● In vitro fertilization
    ● Autoimmune disease (systemic lupus
    erythematous, antiphospholipid
    syndrome)
    SIGNS & SYMPTOMS: Complications :

    Excess weight gain & edema Maternal complications:


    Fluid retention. ● Eclampsia
    ● HELLP Syndrome
    ● Liver damage subcapsular hematoma & hepatic rapture
    ● Kidney injury renal failure - acute tubular necrosis
    ● Hematological: hemorrhage, DIC.
    ● progression to preeclampsia with severe features .

    Fetal complications:
    ● Preterm delivery
    ● Placental abruption
    ● Fetal growth
    restriction
    ● Fetal death
    DIAGNOSIS:

    ● Sustained BP elevation of ≥140/90 mm Hg


    ● Laboratory Abnormalities: Evidence of
    hemoconcentration is shown by elevation of
    hemoglobin, hematocrit, blood urea nitrogen (BUN),
    serum creatinine, and serum uric acid.
    ● Proteinuria of ≥300 mg on a 24 h urine collection or
    protein/creatinine ratio of ≥0.3
    MANAGEMENT:

    ● The only definitive cure is delivery.


    Management is based on gestational age .
    ○ 1) Delivery: at ≥37 weeks’ gestation.
    - Severe preeclampsia: push until 34 weeks and deliver by 34 weeks

    ○ 2) Conservative management . Before 37 weeks’ gestation as long as mother and fetus are
    stable, mild preeclampsia is managed. No antihypertensive agents or MgSO4 are used . Control
    HTN and small dose IM steroids, mainly to promote lung maturity.

    - low-dose aspirin therapy: For High risk patients.


    - daily calcium supplementation: When low calcium intake.
    - Antioxidants

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