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PREECLAMPSIA AND ECLAMPSIA

Definition: The terms preeclampsia and toxemia are used interchangeably. Preeclampsia is defined as elevated blood pressure, severe swelling, and protein in the urine during the second half of pregnancy. It can also occur, although less commonly, after delivery. When preeclampsia progresses untreated, it may result in eclampsiaEclampsia is a worsening of the above with seizures and potentially more serious consequences, including coma and even death.

Diagnosis: During every prenatal visit, your blood pressure will be measured, and your urine checked for protein. Often, you do not have any other symptoms of preeclampsia. Occasionally, patients will present with some of the following:
  • severe swelling, especially in the hands and face
  • headaches not relieved with Tylenol, ice cloths, or rest
  • persistent nausea and vomiting
  • abdominal pain, especially in the upper abdomen
  • blurry vision or seeing spots
Risk factors: Any pregnant woman can develop preeclampsia, although patients with the following conditions are at higher risk.
  • Diabetes
  • high blood pressure (hypertension) prior to pregnancy or in the first trimester
  • chronic kidney disease
  • immune, connective tissue, or blood clotting disorders
  • women at the extremes of age (adolescent or over 40)
  • first pregnancy
  • history of preeclampsia in a previous pregnancy
  • twin or triplet pregnancy
  • obesity
  • African-American race
Diagnosis: The diagnosis of preeclampsia can be made with blood pressure checks , blood work, urine samples (a 24 hour urine collection may be required), and possibly tests to evaluate your baby's health including monitoring your baby's heart rate (non-stress test) or an ultrasound.
Treatment:  Although there is no good way to prevent preeclampsia, good prenatal care will help make the diagnosis early enough so that treatment can be initiated. Hospitalization may be required. Depending on the gestational age at the time of diagnosis, delivery may be indicated. Delivery is the best treatment for preeclampsia, and usually symptoms will resolve within a few weeks to months. Mothers may also be given medications to help prevent seizures (eclampsia). The medication most often used is magnesium sulfate, which is an intravenous medication that must be administered in the hospital under supervision of your doctor. This medication is usually continued through labor, delivery, and the immediate postpartum period. While pregnant, you should rest, especially on your left side, to help increase the blood flow to your baby.
Some research has shown that calcium supplementation, vitamin C, or Vitamin E may help prevent preeclampsia, but further studies are needed.
For more information: Please contact your doctor with any questions, or you can visit the Preeclampsia Foundation's website at www.preeclampsia.org/.




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