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I need a document on eclampsia and pre eclampsia
Around 6 pages
Explanation & Answer
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PRE-ECLAMPSIA,
ECLAMPSIA & HELLP
SYNDROME
PRE- ECLAMPSIA
Defination: Hypertension occuring in pregnancy after 20wks gestation accompanied by
proteinuria and/or pathological oedema.
Also called pregnancy induced hypertension.
NOTE may occur less than 20wk if greater trophoblastic mass eg, molar
pregnancy and multiple pregnancy.
Hypertension; Blood pressure = or > 140/90 or rise of 30mmHg in systolic BP or
15mmHg in diastolic BP above baseline.
Proteinuria; 300mg protein in 24hr urine or > +1 on urine dipstix was
traditionally diagnostic though not inevitably.
Oedema; occurs in 80% of normotensive pregnancies and likewise pre-eclampsia
can occur in absence of protenuria, thus classical triad mentioned above not
useful. Hence pre-eclampsia is hypertension after 20weeks gestation with
involvement of one other organ e.g headache or epigastric pain.
Risk Factors
1.Chronic renal disease
2.Angiotensinogen gene T235
3.Chronic hypertension
4.Antiphospholipid antibody syndrome
5.Multiple gestation
6.Nulliparity
7.Family or personal history of preeclampsia
8.Age > 40 years
9.African-American race
10.Diabetes mellitus
Severe Pre- Eclampsia
Pre-eclampsia can be defined as mild or severe. Severe defined as:
BP > 160/110
Proteinuria > 5g/24hr or 3+ on urine dipstix
Urine output < 500ml/24hr
Increase serum creatinine
Pulmonary oedema or cyanosis
Cerebral involvement; seizures, hyperreflexia, headache, vision changes
Epigastric or RUQ pain
HELLP syndrome
Disseminated Intravascular Complications
Fetal compromise; IUGR, oligohydramnios
Aetiology
Remains unknown but attributed to:
Immunological dysfunction; trophoblastic tissue migrate into maternal circulation
with resultant antigen-antibody complex forming and deposited largely in the
kidneys and placenta.
Endothelial dysfunction; Renin is also produced by placenta and fetal kidney
which results in formation of angiotensin II. In normal pregnancy there is
decreased response to ATII due to counter balancing effect of prostacyclin
(Prostaglandin I2) and NO produced by blood vessels. In pre-eclampsia, these are
reduced with predominant increase of thromboxane.
Coagulation dysfunction; Hype...