Mild or Severe Pre-eclampsia

Posted On: January 28, 2016 By Andrei Rebarber, MD

Preeclampsia may present solely with hypertension and protein in the urine or these features may be combined with multisystem organ dysfunction (eg kidney, liver, blood system abnormalities). Onxe the diagnosis is made there is always the concern about the evolution of disorder and doctors recognize it as a potentially progressive process if not appropriately treated. Approximately 1-2 % of women develop eclampsia (ie. Seizures) secondary to the severity of the disorder’s effect on the brain. Unfortunately, physicians do not yet have clinically robust predictors of when it will quickly become severe. Preeclampsia is generally defined as the new onset of hypertension combined with either proteinuria or various end-organ abnormalities. The modern terminology for pre-eclampsia, includes primarily either preeclampsia and preeclampsia with severe features, thus primarily indicating the potential in all cases , even those with more a milder appearance, that an evolution into a more severe process can occur. Atypical presentation of the disorder may include: onset of signs and symptoms prior to 20 weeks gestation, end-organ abnormalities (ie. HELLP syndrome) without elevation of blood pressure, and finally delayed postpartum onset or exacerbation (> 2 days postpartum)

Gestational hypertension is defined as new onset hypertension (³ 140 systolic and or 90 diastolic BP) after 20 weeks gestation without proteinuria or end-organ dysfunction. It is the most common cause of hypertension in pregnancy with a prevalence of 6-17% of healthy first time mothers. Depending on the studies reviewed 10-50% of women with gestational hypertension go on to develop overt preeclampsia in 1-5 weeks from initial diagnosis.

It is important to realize how serious of a condition this disease can become and is critical for doctors to monitor the fetus more aggressively than a regular pregnancy in those pregnancies at risk or once the diagnosis is made. As the sole cure for this disorder is delivery, physicians may need to intervene and delivery an infant earlier than full term, to minimize the risk for both the fetus and the mother. In the preterm period, in most circumstances, physicians try to administer antenatal steroids and magnesium sulfate prior to delivery in order to help the premature infant have a better outcome.

Carnegie Imaging for Women blogs are intended for educational purposes only and do not replace certified professional care. Medical conditions vary and change frequently. Please ask your doctor any questions you may have regarding your condition to receive a proper diagnosis or risk analysis. Thank you!

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