Pre-eclampsia & Eclampsia
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Pre-eclampsia & Eclampsia
Pregnancy-Induced Hypertension [PIH]; Toxemia of Pregnancy
Basic Information
DESCRIPTION
This refers to a serious disturbance in blood pressure, kidney function and the central nervous system that may occur from the 20th week of pregnancy until seven days after delivery. Eclampsia is an extension of the preeclampsia process.
FREQUENT SIGNS AND SYMPTOMS
Mild Preeclampsia (mild PIH):
- Significant blood pressure rise, even if still in the normal range
- Puffiness in the face, hands and feet that is worse in the morning
- Excessive weight gain (more than a pound a week during the last trimester)
Severe Preeclampsia (sever PIH):
- Continued blood pressure rise
- Continued swelling and puffiness
- Blurred vision
- Headache
- Irritability
- Abdominal pain
Eclampsia:
- Worsening of above symptoms
- Muscle twitching
- Seizures
- Coma
CAUSES
While unknown, it is believed to be caused by a substance or toxin produced by the placenta.
RISK INCREASES WITH…
- Poor nutrition
- Diabetes mellitus
- Pre-pregnancy high blood pressure
- Chronic kidney disease
- Immune disorders, such as lupus
- First pregnancy
- Preeclampsia during one pregnancy does not mean it will recur with subsequent pregnancies, but it does increase the risk or recurrence
- Obesity
- Multiple gestation (twins)
- Family history of preeclampsia or eclampsia
PREVENTIVE MEASURES
- Obtain good prenatal care throughout pregnancy.
- Eat a normal, well-balanced diet during pregnancy. Take prenatal vitamin and mineral supplements, if prescribed.
- Don't use medications of any kind, including nonprescription drugs, without medical advice.
EXPECTED OUTCOME
If diagnosed and treated throughout the pregnancy, the problem usually disappears without complications within 7 days after delivery. Severe PIH and hypertensive disease continues to be a significant contributor to maternal mortality. If premature labor occurs, the newborn&'s survival chances depend on its maturity. Fetal death is common.
POSSIBLE COMPLICATIONS
- Stroke
- Increased risk of high blood pressure unrelated to pregnancy after age 30
- Seizures
- Pulmonary edema
- Kidney failure
Treatment
GENERAL MEASURES
- Diagnostic tests may include laboratory blood studies, 24 hour urine study (to check protein levels), and others to rule out complications.
- Treatment will depend on severity of the signs and symptoms, and the maturity of the fetus. Home care for mild symptoms, hospital care if the condition deteriorates, and early delivery if the situation is severe. Eclampsia, because of seizure activity, is more likely to require hospital care and rapid delivery (often cesarean section).
- If you are at home, weigh yourself daily and keep a record. Use a home test to check for protein in the urine (instructions will be provided).
MEDICATION
- Antihypertensive drugs, if needed to lower blood pressure, are generally only used in acute situations, unless you have been on hypertension therapy prior to pregnancy.
- Anticonvulsant to prevent seizures. High dose magnesium is the most widely accepted anticonvulsant used.
ACTIVITY
Rest often; this is important in controlling preeclampsia. Rest on your left side to help circulation.
DIET
Your doctor will advise you if a special diet is necessary.
Notify our Office if…
- You or a family member has symptoms of preeclampsia at any stage of pregnancy.
- The following occur during treatment:
- Severe headache or vision disturbance.
- Weight gain of 3 or more pounds in 24 hours.
- Nausea, vomiting and diarrhea.
- Cramping abdominal pains.
- Excessive irritability.