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Aetiology and presentation of pre-eclampsia and eclampsia.
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Pre-eclampsia (gestational proteinuric hypertension) is defined as pregnancy induced sustained hypertension BP over 140/90 (in an normotensive woman) developing after 20 weeks gestation, in association with new-onset proteinuria (+1 without UTI). May present with oedema in hands and face.
Aet: Idiopathic disease of the placenta where arterial walls fail to distend to accommodate required blood flow, resulting in raised BP and a toxemia factor. Increased risk in <20, >35, family Hx, first pregnancy with new partner, hydatidiform mole, multip, obesity, pregestational diabetes/htn. LOWER incidence in smokers, though disease progression is worse. Eclampsia complicates 1/2000 pregnancies and is characterised by generalized convulsions and/or coma, with the signs and symptoms of pre-eclampsia. Rule out idiopathic epilepsy, subarachnoid haemorrhage, meningitis etc. |
