Preeclampsia

*http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001900/

Preeclampsia is a pregnancy condition in which high blood pressure and protein in the urine develop after the 20th week (late 2nd or 3rd trimester) of pregnancy.

Causes, incidence, and risk factors

The exact cause of preeclampsia is not known. Possible causes include:

Preeclampsia occurs in a small percentage of pregnancies. Risk factors include:

  • First pregnancy
  • Multiple pregnancy (twins or more)
  • Obesity
  • Older than age 35
  • Past history of diabetes, high blood pressure, or kidney disease

Symptoms

Often, women who are diagnosed with preeclampsia do not feel sick.

Symptoms of preeclampsia can include:

  • Swelling of the hands and face/eyes (edema)
  • Weight gain
    • More than 2 pounds per week
    • Sudden weight gain over 1 – 2 days

Note: Some swelling of the feet and ankles is considered normal with pregnancy.

Symptoms of more severe preeclampsia:

  • Headaches that are dull or throbbing and will not go away
  • Abdominal pain, mostly felt on the right side, underneath the ribs. Pain may also be felt in the right shoulder, and can be confused with heartburn, gallbladder pain, a stomach virus, or the baby kicking
  • Agitation
  • Decreased urine output, not urinating very often
  • Nausea and vomiting (worrisome sign)
  • Vision changes — temporary loss of vision, sensations of flashing lights, auras, light sensitivity, spots, and blurry vision

Signs and tests

The doctor will perform a physical exam and order laboratory tests. Signs of preclampsia include:

  • High blood pressure, usually higher than 140/90 mm/Hg
  • Protein in the urine (proteinuria)

The physical exam may also reveal:

  • Swelling in the hands and face
  • Weight gain

Blood and urine tests will be done. Abnormal results include:

  • Protein in the urine (proteinuria)
  • Higher-than-normal liver enzymes
  • Platelet count less than 100,000 (thrombocytopenia)

Your doctor will also order tests to see how well your blood clots, and to monitor the health of the baby. Tests to monitor the baby’s well-being include pregnancy ultrasoundnon-stress test, and a biophysical profile. The results of these tests will help your doctor decide whether your baby needs to be delivered immediately.

Women who began their pregnancy with very low blood pressure, but had a significant rise in blood pressure need to be watched closely for other signs of preeclampsia.

Treatment

The only way to cure preeclampsia is to deliver the baby.

If your baby is developed enough (usually 37 weeks or later), your doctor may want your baby to be delivered so the preeclampsia does not get worse. You may receive different treatments to help trigger labor, or you may need a c-section.

If your baby is not fully developed and you have mild preeclampsia, the disease can often be managed at home until your baby has a good chance of surviving after delivery.

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