Preeclampsia and Eclampsia

Preeclampsia (formerly referred to as Toxemia) is a condition of pregnancy that occur after the 20th week or shortly after delivery in women with previously normal blood pressure develops high blood pressure and protein in the urine, characterised by swelling of the feet and hands.
Preeclampsia is a common condition in pregnant women but if not treated well may become severe for both mother and foetus.

Severe pre-eclampsia is defined as diastolic blood pressure (BP) of at least 110 mm Hg or systolic BP of at least 160 mm Hg, and/or symptoms, and/or biochemical and/or haematological impairment. In severe cases, the fetus and/or newborn may have neurological damage induced by Hypoxia (deficiency in the amount of oxygen reaching the tissues). Fetal complications of preeclampsia include the risk of preterm delivery, oligohydramnios (low fluid volume within the uterus), and sub-optimal fetal growth.

Eclampsia : This is the development of seizures in women with severe preeclampsia. Both Preeclampsia and Eclampsia are peculiar to first time pregnancies.

Who is at risk of having Preeclampsia

  1. First pregnancy
  2. 10years of more of last pregnancy
  3. Family history of preeclampis
  4. Teens and women above 40 years
  5. History of high blood pressure, diabetes or kidney disease prior to pregnancy
  6. Multiple pregnancy
  7. History of obesity
  8. Black women
  9. History of preeclampsia in previous pregnancy
  10. Pregnancy through egg donation or donor insemination
  11. Sickle cell disease

Causes
The causes of Preeclampsia and Eclampsia are unknown but may be connected to abnormal placental development, disorder of the lining of blood vessels, immune system and some genetic and environmental factors.
When preeclampsia goes unnoticed and untreated it leads to Eclampisa.

Signs and Symptoms of Preeclampsia
. Severe headache
. Rapid weight gain
. Dizziness
. Reflex change
. Reduction in urine or none
. Visual disturbances: Blurred, scintillating scotomata
. Altered mental status
. Blindness: May be cortical or retinal
. Dyspnea - difficult or laboured breathing
. Edema: Sudden increase in edema or facial edema
. Epigastric or right upper quadrant abdominal pain
. Weakness or malaise: May be evidence of hemolytic anemia
. Clonus: May indicate an increased risk of convulsions

Treatment
1.Hospitalization and sometimes antihypertensive treatment
2.Delivery, depending on factors such as gestational age, evidence of fetal maturity, and severity of preeclampsia
3. Magnesium sulfate for prevention or treatment of seizures
4. Hydralazine or another antihypertensive drug to manage severe blood pressure elevations
5. Monitoring fluid intake and urine output.

References: www.patient.info, www.medicinenet.com, www.webmd.com, www.merckmanuals.com, www.emedicine.medscape.com