Pre-eclampsia
- new onset of hypertension and proteinuria (> 0.3 g protein in 24 hour urine specimen or persistent 1+ on dipstick) after 20 weeks of gestation in previously normotensive women
- occurrence of pre-eclampsia signs and symptoms prior to 20 weeks is rare; when present this suggests molar pregnancy
- must be distinguished from: a) chronic hypertention - bp > 140/90 before the 20th week of pregnancy b) gestational hypertension - hypertension w/o proteinuria
- complications of more severe disease: microangiopathic hemolysis, hepatic injury, headache, blurred vision
- diagnosis: hypertension should be confirmed at least 6 hours apart and proteinuria noted on dipstick should be confirmed by quantitative method; consider checking other labs as dictated by concern for severe disease
- treatment: depends on severity of disease and gestational age; more severe disease and greater gestational age make delivery the irrefutable option.
- patients w/ severe pre-eclampsia should also receive magnesium and BP control w/ labetalol if BP > 150/100.
Source
August, P. et al. "Clinical features, diagnosis, and long-term prognosis of preeclampsia" Up to date. 20 Feb 2008. <http://www.uptodate.com>
Norwitz, E. et al. "Management of preeclampsia." Up to date. 29 Aug 2007. <http://www.uptodate.com>