Preeclampsia

Injury	Disease	Nutrition	Poison

Symptoms	Surgery	Test	Special Topic

Preeclampsia

Preeclampsia

Alternative Names:

Toxemia; Pregnancy-induced hypertension
Treatment:

Currently, theonly way to cure preeclampsia is to deliver the baby. However, if that delivery would be very premature, the disease may be managed by bed rest, close monitoring, and delivery as soon as the fetus has a good chance of surviving outside the womb.

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Patients are usually hospitalized, but occasionally they may be managed on an outpatient basis with careful monitoring of blood pressure, urine checks for protein, and weight.

Optimally, attempts are made to manage the condition until a delivery after 36 weeks of pregnancy can be achieved.

Labor may be induced if any of the following occur:

Diastolic blood pressure greater than 100 mmHg consistently for a 24 hour period, or any confirmed reading over 110 mmHg
Persistent or severe headache
Abdominal pain
Abnormal liver function tests
Rising serum creatinine
HELLP syndrome
Pulmonary edema (fluid in lungs)
Eclampsia
Thrombocytopenia (low platelet count)
Non-reassuring fetal monitoring tracings
Failure of fetal growth noted by ultrasound
Abnormal biophysical profile (a test to monitor the health of the fetus)

In cases of severe preeclampsia when the pregnancy is between 32 and 34 weeks, delivery is the treatment of choice. For pregnancies less than 24 weeks, the induction of labor is recommended, although the likelihood that the fetus will survive is very small.

Prolonging pregnancies has been shown to result in maternal complications, as well as infant death in approximately 87% of cases. Pregnancies between 24 and 34 weeks gestation present a "gray zone," and the medical team and the parents may decide to attempt to delay delivery in order to allow the fetus to mature.

During this time, the mother is treated with steroid injections which help speed the maturity of some fetal organs including the lungs. The mother and baby are closely monitored for complications.

During induction of labor and delivery, medications are given to prevent seizures and to keep blood pressure under good control. The decision for vaginal delivery versus Cesarean section is based on how well the fetus is able totolerate labor.

Expectations (prognosis):

Maternal deaths caused by preeclampsia are rare in the U.S. Fetal or perinatal deaths are high and generally decrease as the fetus matures. The risk of recurrent preeclampsia in subsequent pregnancies is approximately 33%. Preeclampsia does not appear to lead to chronic high blood pressure.

Complications:

Preeclampsia may develop into eclampsia, the occurrence of seizures. Fetal complications may occur because of prematurity at time of delivery.

Calling your health care provider:

Call your health care provider if symptoms occur during pregnancy.