5-Minute Emergency Consult
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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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
Rosen, Peter, et al., editors. "Preeclampsia/eclampsia." 5-Minute Emergency Consult, 5th ed., Lippincott Williams & Wilkins, 2016. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307085/all/Preeclampsia_eclampsia.
Preeclampsia/eclampsia. In: Rosen P, Shayne P, Barkin AZ, et al, eds. 5-Minute Emergency Consult. 5th ed. Lippincott Williams & Wilkins; 2016. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307085/all/Preeclampsia_eclampsia. Accessed January 17, 2020.
Preeclampsia/eclampsia. (2016). In Rosen, P., Shayne, P., Barkin, A. Z., Wolfe, R. E., Hayden, S. R., Barkin, R. M., & Schaider, J. J. (Eds.), 5-Minute Emergency Consult. Available from https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307085/all/Preeclampsia_eclampsia
Preeclampsia/eclampsia [Internet]. In: Rosen P, Shayne P, Barkin AZ, Wolfe RE, Hayden SR, Barkin RM, Schaider JJ, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. [cited 2020 January 17]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307085/all/Preeclampsia_eclampsia.
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