Preeclampsia/eclampsia
Preeclampsia/eclampsia is a topic covered in the 5-Minute Emergency Consult.
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Basics
Description
Description
- Hypertension in pregnancy:
- 1% of all pregnancies
- 16% of maternal deaths
- Gestational hypertension (GH)
- Hypertension associated with pregnancy
- Resolves with delivery
- 6–7% of all pregnancies
- Preeclampsia
- GH PLUS proteinuria
- 2.2–6.3% of all pregnancies
- Eclampsia
- Preeclampsia with seizure
- Postpartum preeclampsia
- Occurs within 6 wk of delivery
- Usually no history of hypertension
- Occurs in 5% patients
- Most women are African American
- HELLP syndrome
- May occur in women with preeclampsia or eclampsia
- Hemolysis
- Elevated liver function tests
- Low platelets
- Superimposed preeclampsia
- Preeclampsia in the setting of chronic hypertension
- Complicates pregnancy in up to 25% of women with chronic hypertension
- Risk factors:
- African American
- Antihypertensive medication use
- Chronic hypertension
- Systolic BP (SBP) >140 or diastolic BP (DBP) >90
- Measured twice prior to 20 wk gestation or lasting >12 wk after delivery
Etiology
Etiology
- Preeclampsia
- Incomplete placental implantation and underperfusion
- Leads to decreased angiogenic growth factor and increased maternal placental debris in circulation
- Eclampsia
- 1/3 of patients with eclampsia did not have hypertension prior to seizure
- Risk factors:
- Extremes of reproductive age
- Primagravida
- Multiple gestations
- Molar pregnancy, hydatidiform mole
- Smoking
- Increased body mass index
- Diabetes, collagen vascular diseases
- Pre-existing hypertension or renal disease
- History of preeclampsia with prior pregnancies (7.5–10% increased risk)
- Independent risk factors for eclampsia
- Nulliparity
- Maternal age
- GH
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Citation
* When formatting your citation, note that all book, journal, and database titles should be italicized* Article titles in AMA citation format should be in sentence-case
TY - ELEC
T1 - Preeclampsia/eclampsia
ID - 307085
ED - Barkin,Adam Z,
ED - Barkin,Roger M,
ED - Hayden,Stephen R,
ED - Rosen,Peter,
ED - Schaider,Jeffrey J,
ED - Shayne,Philip,
ED - Wolfe,Richard E,
BT - 5-Minute Emergency Consult
UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307085/all/Preeclampsia_eclampsia
PB - Lippincott Williams & Wilkins
ET - 5
DB - Emergency Central
DP - Unbound Medicine
ER -