PREECLAMPSIA & ECLAMPSIA

(Pregnancy-Induced Hypertension; Toxemia)

 Basic information

description

Preeclampsia and eclampsia are serious problems of pregnancy. They may develop from the 20th week of pregnancy up to 6 weeks after delivery. Preeclampsia is high blood pressure and protein in the urine. Eclampsia includes seizures and possibly coma. Eclampsia may follow preeclampsia or occur on its own.

FREQUENT SIGNS & SYMPTOMS

• Mild preeclampsia usually has no symptoms. It can be diagnosed on a routine pregnancy check-up.
• More severe preeclampsia symptoms may include:
  • Swelling (edema) of the hands and face.
  • Rapid weight gain.
  • Changes in vision.
  • Headache.
  • Changes in mental status.
  • Nausea or vomiting and abdominal pain.
  • Low urine output.
  • Other symptoms can occur with complications.
• Eclampsia symptoms include seizures or coma.

causes

Exact cause is unknown. A dysfunction of the placenta may start the process that leads to other problems.

risk increases with

• First pregnancy or first pregnancy with new partner.
• Preeclampsia in a previous pregnancy.
• Family history of preeclampsia or eclampsia.
• Obesity.
• Multiple gestation (twins, triplets, etc.).
• Mother's age over 40 or less than 20.
• Prolonged time between pregnancies.
• African American women.
• Diabetes prior to pregnancy or gestational diabetes.
• Chronic medical problems before pregnancy (e.g., high blood pressure, kidney disease, vascular or connective tissue disorders, or thrombophilic diseases).
• Medical problems during pregnancy, such as urinary tract infection, and others.
• Complications of pregnancy, such as chromosome abnormalities, and others.

PREVENTIVE MEASURES

None specific. Research is ongoing. Regular prenatal care will help find abnormal blood pressure early.

expected outcomes

The cure is to deliver the baby. Complications for mother and baby can often be prevented with prompt diagnosis and treatment. The high blood pressure and other symptoms usually resolve within days to weeks after delivery. If premature labor occurs, the newborn's survival chances depend on its maturity.

possible complications

• Mother—placenta abruption, stroke, kidney failure, seizures, high blood pressure, HELLP syndrome (form of severe preeclampsia), hemorrhage, pulmonary edema, heart failure, and death.
• Baby—premature birth, low birth weight, intrauterine growth restriction, and stillbirth.

 diagnosis & treatment

general measures

• Diagnostic tests may include blood pressure tests, blood studies, 24-hour urine study (to check the protein levels), and ultrasound (to assess fetal development). Other tests may be done if complications occur.
• Treatment will depend on results of medical tests, the severity of the symptoms, and how far along you are in the pregnancy. In some cases, mild preeclampsia may be treated as an outpatient. Hospital care is needed if the condition worsens or for early delivery. Eclampsia, because of seizure activity, requires hospital care.
• The decision to have a vaginal delivery or cesarean section is based on each individual's situation.
• To learn more: Preeclampsia Foundation, 5353 Wayzata Blvd., Suite 207, Minneapolis, MN 55416; (800) 665-9341; website: www.preeclampsia.org.

medications

• Drugs may be given for high blood pressure, to prevent or control seizures, or to induce labor.
• Corticosteroids may be given for complications or to help mature the baby's lungs before delivery.

activity

You will be advised of any limits. Bedrest at home may be recommended in some cases.

diet

Usually, no special diet is needed.

 notify our office if

• You or a family member has any of the symptoms of preeclampsia or eclampsia at any stage of pregnancy.
• Any symptoms occur during pregnancy or after delivery that cause you concern.

Special Notes: