PREECLAMPSIA

Source: TelegraphIndia

Disclaimer: Copyright infringement not intended.

Context

• World Preeclampsia Day, observed annually on May 22nd, aims to raise crucial awareness about preeclampsia, a potentially life-threatening pregnancy complication.

Details

• Preeclampsia is a pregnancy-related disorder characterized by high blood pressure and often a significant amount of protein in the urine.
• It usually occurs after the 20th week of pregnancy and can also develop postpartum.
• Preeclampsia can have severe complications for both the mother and the baby if not managed properly.

Etiology

The exact cause of preeclampsia is unknown, but several factors contribute to its development:

• Genetic predisposition: Family history of preeclampsia.
• Immunologic factors: Abnormal immune response to the placenta.
• Vascular factors: Dysfunctional development of blood vessels in the placenta.
• Other risk factors: Obesity, chronic hypertension, diabetes, first pregnancy, age (young or older mothers), and multiple pregnancies.

Physiology

Preeclampsia is believed to result from abnormal placentation, leading to:

• Endothelial dysfunction: Widespread damage to the cells lining the blood vessels.
• Vasoconstriction: Narrowing of the blood vessels, leading to hypertension.
• Increased permeability: Leading to proteinuria and edema.
• Systemic inflammatory response: Contributing to multi-organ involvement.

Symptoms

• Hypertension: Blood pressure ≥140/90 mmHg.
• Proteinuria: Presence of ≥300 mg of protein in a 24-hour urine sample.
• Edema: Swelling, especially in the face and hands.
• Other symptoms: Severe headaches, visual disturbances, upper abdominal pain, and sudden weight gain.

Complications

Maternal Complications

• Eclampsia: Seizures occurring in a woman with preeclampsia.
• HELLP syndrome: Hemolysis, Elevated Liver enzymes, Low Platelet count.
• Stroke: Due to severely elevated blood pressure.
• Organ damage: Kidney, liver, and other organs.

Fetal Complications

• Intrauterine growth restriction (IUGR): Poor growth of the baby due to placental insufficiency.
• Preterm birth: Early delivery to manage severe preeclampsia.
• Placental abruption: Premature separation of the placenta from the uterus.

Medical Treatment

• Antihypertensive medications: To control blood pressure (e.g., labetalol, methyldopa).
• Magnesium sulfate: To prevent seizures in severe preeclampsia/eclampsia.
• Corticosteroids: To accelerate fetal lung maturity if preterm delivery is anticipated.

Sources:

TelegraphIndia

PRACTICE QUESTION Q. Consider the following statements regarding preeclampsia: Preeclampsia is a condition characterized by high blood pressure and proteinuria during pregnancy. It usually occurs before the 20th week of pregnancy. Preeclampsia can have serious health implications for both the mother and the baby if not managed properly. Which of the statements given above is/are correct? A) 1 only B) 1 and 3 only C) 2 and 3 only D) 1, 2, and 3 Answer: B)