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Pre-eclampsia

Pre-eclampsia is defined as:
  • Hypertension 
    • systolic >140mmHg or diastolic ≥ 90mmHg
    • ‘severe’ preeclampsia if systolic ≥ 170mmHg or diastolic ≥ 110mmHg 
  • Proteinuria 
  • Occurring after 20 weeks gestation 

Pre-eclampsia is a complication in 3-8% of pregnancies 
Severe pre-eclampsia occurs in 0.5% of pregnancies 

Possible features of severe pre-eclampsia include: 
  • Headaches 
  • Blurred vision 
  • Abdominal pain - epigastric 
  • Oedema
  • Clonus 
  • Liver tenderness 
  • Platelets <100 
  • Abnormal LFTs
  • HELLP syndrome

Risk factors for pre-eclampsia include: 
  • Antiphospholipid syndrome 
  • Renal disease 
  • SLE 
  • Nulliparity 
  • Chronic hypertension 
  • Diabetes 
  • Obesity 
  • Multiple gestations 
  • Advanced maternal age (> 40 years) 

Management:
  • Control blood pressure – labetalol, nifedipine or hydralazine 
  • Magnesium sulphate should be considered if eclampsia is considered a risk
  • Definitive treatment is to deliver baby 


References
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Secret collector of interesting anonymised ECGs. Fan of the Bath Photomarathon. Lover of cream teas. [Sarah Hudson] (Your Picture)