Pre-eclampsia ( PE )

                            Pre-eclampsia or Preeclampsia is a hypertensive disorder of pregnancy. Two other symptoms, proteinuria and edema (generalized fluid retention or swelling), complete the classic triad of pre-eclampsia. Pre-eclampsia is much more common in the first pregnancy (3-5% of births) and usually becomes evident in the third trimester (always after the 20th week of pregnancy).

In severe disease there may be red blood cell breakdown, a low blood platelet count, impaired liver function, kidney dysfunction, swelling, shortness of breath due to fluid in the lungs, or visual disturbances. PE increases the risk of poor outcomes for both the mother and the baby. If left untreated, it may result in seizures at which point it is known as eclampsia.

Causes 
There is no definitive known cause of preeclampsia, though it is likely related to a number of factors. Some of these factors include :
- Abnormal placentation (formation and development of the placenta)
- Immunologic factors
- Prior or existing maternal pathology
- Dietary factors, e.g. calcium supplementation in areas where dietary calcium intake is low has been shown to reduce the risk of preeclampsia
- Environmental factors, e.g. air pollution

Related Article :
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-   Causes of Secondary Hypertension


Diagnostic Criteria
1. Blood pressure ≥ 140 mm Hg systolic or ≥ 90 mm Hg diastolic on two separate readings taken at least four to six hours apart after 20 weeks gestation in an individual with previously normal blood pressure.
2. In a woman with essential hypertension beginning before 20 weeks gestational age, the diagnostic criteria are: an increase in systolic blood pressure (SBP) of ≥30mmHg or an increase in diastolic blood pressure (DBP) of ≥15mmHg.
3. Proteinuria ≥ 0.3 grams (300 mg) or more of protein in a 24-hour urine sample or a SPOT urinary protein to creatinine ratio ≥ 0.3 or a urine dipstick reading of 1+ or greater (dipstick reading should only be used if other quantitative methods are not available).

Complication
1. Eclampsia
2. HELLP Syndrome
3. Hemorrhagic or ischemic stroke
4. Liver damage and dysfunction
5. Acute kidney injury
6. Acute Respiratory Distress Syndrome (ARDS).

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