Pre-eclampsia is a disorder of pregnancy involving new-onset hypertension (systolic BP ≥140 mmHg or diastolic BP ≥90 mmHg) and involvement of one or more other organ systems.
Pre-eclampsia affects up to 8% of pregnancies 1.
- diabetes mellitus 2
- chronic hypertension 2
- family history 2
- nulliparity 2
- advanced maternal age (>40 years) 2
- obesity 2
Pre-eclampsia involves new-onset hypertension after 20 weeks gestation in pregnancy and up to 4-6 weeks postpartum with one or more of:
- renal impairment (doubling of serum creatinine)
- liver impairment (doubling of hepatic transaminases)
- pulmonary edema
- headache or visual disturbance
The addition of tonic-clonic seizures is known as eclampsia.
The exact etiology of pre-eclampsia is still not fully understood. Although central to its development is believed to be the defective development of spiral placental arteries and subsequent placental ischemia.
- mean uterine artery PI may be above 95th percentile
Treatment and prognosis
The only cure for pre-eclampsia is delivery of the fetus. Pre-eclampsia is a major source of maternal and fetal morbidity and mortality 4.
- 1. Hypertension in pregnancy. Report of the American College of Obstetricians and Gynecologists’ Task Force on Hypertension in Pregnancy. (2013) Obstetrics and gynecology. 122 (5): 1122-31. doi:10.1097/01.AOG.0000437382.03963.88 - Pubmed
- 2. ACOG technical bulletin. Hypertension in pregnancy. Number 219--January 1996 (replaces no. 91, February 1986). Committee on Technical Bulletins of the American College of Obstetricians and Gynecologists. (1996) International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics. 53 (2): 175-83. Pubmed
- 3. Gathiram P, Moodley J. Pre-eclampsia: its pathogenesis and pathophysiolgy. (2016) Cardiovascular journal of Africa. 27 (2): 71-8. doi:10.5830/CVJA-2016-009 - Pubmed
- 4. Chang WN, Lui CC, Chang JM. CT and MRI findings of eclampsia and their correlation with neurologic symptoms. (1996) Zhonghua yi xue za zhi = Chinese medical journal; Free China ed. 57 (3): 191-7. Pubmed