User:Mr. Ibrahem/Pre-eclampsia
Medical condition / From Wikipedia, the free encyclopedia
Pre-eclampsia (PE) is a disorder of pregnancy characterized by the onset of high blood pressure and often a significant amount of protein in the urine.[1][8] When it arises, the condition begins after 20 weeks of pregnancy.[2][3] 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.[2][3] Pre-eclampsia increases the risk of poor outcomes for both the mother and the baby.[3] If left untreated, it may result in seizures at which point it is known as eclampsia.[2]
Pre-eclampsia | |
---|---|
Other names | Preeclampsia toxaemia (PET) |
A micrograph showing hypertrophic decidual vasculopathy, a finding seen in gestational hypertension and pre-eclampsia. H&E stain. | |
Specialty | Obstetrics |
Symptoms | High blood pressure, protein in the urine[1] |
Complications | Red blood cell breakdown, low blood platelet count, impaired liver function, kidney problems, swelling, shortness of breath due to fluid in the lungs, eclampsia[2][3] |
Usual onset | After 20 weeks of pregnancy[2] |
Risk factors | Obesity, prior hypertension, older age, diabetes mellitus[2][4] |
Diagnostic method | BP > 140 mmHg systolic or 90 mmHg diastolic at two separate times[3] |
Prevention | Aspirin, calcium supplementation, treatment of prior hypertension[4][5] |
Treatment | Delivery, medications[4] |
Medication | Labetalol, methyldopa, magnesium sulfate[4][6] |
Frequency | 2–8% of pregnancies[4] |
Deaths | 46,900 hypertensive disorders in pregnancy (2015)[7] |
Risk factors for pre-eclampsia include obesity, prior hypertension, older age, and diabetes mellitus.[2][4] It is also more frequent in a woman's first pregnancy and if she is carrying twins.[2] The underlying mechanism involves abnormal formation of blood vessels in the placenta amongst other factors.[2] Most cases are diagnosed before delivery. Rarely, pre-eclampsia may begin in the period after delivery.[3] While historically both high blood pressure and protein in the urine were required to make the diagnosis, some definitions also include those with hypertension and any associated organ dysfunction.[3][9] Blood pressure is defined as high when it is greater than 140 mmHg systolic or 90 mmHg diastolic at two separate times, more than four hours apart in a woman after twenty weeks of pregnancy.[3] Pre-eclampsia is routinely screened for during prenatal care.[10][11]
Recommendations for prevention include: aspirin in those at high risk, calcium supplementation in areas with low intake, and treatment of prior hypertension with medications.[4][5][12] In those with pre-eclampsia delivery of the baby and placenta is an effective treatment.[4] When delivery becomes recommended depends on how severe the pre-eclampsia and how far along in pregnancy a woman is.[4] Blood pressure medication, such as labetalol and methyldopa, may be used to improve the mother's condition before delivery.[6] Magnesium sulfate may be used to prevent eclampsia in those with severe disease.[4] Bedrest and salt intake have not been found to be useful for either treatment or prevention.[3][4]
Pre-eclampsia affects 2–8% of pregnancies worldwide.[4] Hypertensive disorders of pregnancy (which include pre-eclampsia) are one of the most common causes of death due to pregnancy.[6] They resulted in 46,900 deaths in 2015.[7] Pre-eclampsia usually occurs after 32 weeks; however, if it occurs earlier it is associated with worse outcomes.[6] Women who have had pre-eclampsia are at increased risk of heart disease and stroke later in life.[10] The word "eclampsia" is from the Greek term for lightning.[13] The first known description of the condition was by Hippocrates in the 5th century BC.[13]