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    Preeclampsia/eclampsia

    Preeclampsia/eclampsia is a topic covered in the 5-Minute Emergency Consult.

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    Basics

    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

    • 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 -