Pre Eclampsia Essay
Definition
Pre-eclampsia is pregnancy induced hypertension usually accompanied by raised blood pressure and proteinuria, mainly diagnosed after week 20 and convulsion may occur. From 3% to 7% affected by pre-eclampsia and it is the major cause for morbidity and mortality. Diabetes, chronic hypertension and obesity are the main risk factors for pre-eclampsia (Maeda, 1954).
It classified into three categories
1. Mild 150/99 mmHg
2. Moderate 160/109 mmHg
3. Severe < 160/110mmHg Causes
1. Excessive inflammation
2. Angiogenic imbalance
3. Enlarged uterus
4. Metabolic changes
5. Immunological disorders
6. Blood vessels damage
Symptoms
1. Headache
2. Weight gain
3. Edema
4. Blurred vision
5. Abdominal pain
6. Nausea and vomiting
7. Impaired liver function
8. Thrombocytopenia
9. Proteinuria which is an excessive loss of protein in urine
10. Kidney disorder
Diagnosis
First, class of hypertension must be identified as mild, moderate or severe. Measurement stated that hypertension in pregnancy is greater than 160/110mmHg. Blood pressure is measured continually for confirmation of hypertension type during pregnancy. Second, proteinuria level is measured, but it is not a specific test. Level of protein in blood is about 3 g/l over 24 hour urine test (Maeda 2013).
Biochemical changes
1. Serum creatinine is more than 0.09 units and oliguria
2. …show more content…
Transaminases are increased up to 70 iu/L
3. Platelets count less than 100× 109
4. High serum uric acid
Treatment
The only suitable way for treatment is delivery and management of the case will depend on severity of pre-eclampsia.
For treatment, antihypertensive drugs are necessary to decrease the risk of hemorrhage or acute pulmonary edema. . Nicardipine, labetalol, clonidine, and dihydralazine are the main antihypertensive drugs prescribed for first line treatment. Corticosteroids are taken to reduce the risk of neonatal mortality and intra-vnetricular hemorrhage. For second line treatment, magnesium sulfate is recommended in convulsion treatment. Also, diuretics are added to antihypertensive drugs such as furosemides (Yellon,
2010).
Prevention
It based on the risk factors such as genetic risk factors, family history of pre- eclampsia, immunologic factors and demographic factors such as a maternal age >35 to predict pre-eclampsia early and easily deal with it before taken any medications. Doctors usually advice to rest and reduce any physical activities, sometimes bed rest is recommended for fetal surveillance calcium and vitamin D supplements are required, low dose acetylsalicylic acid for high risk pregnant women, magnesium sulfate intake, antihypertensive drugs in case of hypertension to avoid development of pre-ecalmpsia and heparin in case of thrombophilia complication (Uzan, 2011).
Pre-eclampsia is pregnancy induced hypertension usually accompanied by raised blood pressure and proteinuria, mainly diagnosed after week 20 and convulsion may occur. From 3% to 7% affected by pre-eclampsia and it is the major cause for morbidity and mortality. Diabetes, chronic hypertension and obesity are the main risk factors for pre-eclampsia (Maeda, 1954).
It classified into three categories
1. Mild 150/99 mmHg
2. Moderate 160/109 mmHg
3. Severe < 160/110mmHg Causes
1. Excessive inflammation
2. Angiogenic imbalance
3. Enlarged uterus
4. Metabolic changes
5. Immunological disorders
6. Blood vessels damage
Symptoms
1. Headache
2. Weight gain
3. Edema
4. Blurred vision
5. Abdominal pain
6. Nausea and vomiting
7. Impaired liver function
8. Thrombocytopenia
9. Proteinuria which is an excessive loss of protein in urine
10. Kidney disorder
Diagnosis
First, class of hypertension must be identified as mild, moderate or severe. Measurement stated that hypertension in pregnancy is greater than 160/110mmHg. Blood pressure is measured continually for confirmation of hypertension type during pregnancy. Second, proteinuria level is measured, but it is not a specific test. Level of protein in blood is about 3 g/l over 24 hour urine test (Maeda 2013).
Biochemical changes
1. Serum creatinine is more than 0.09 units and oliguria
2. …show more content…
Transaminases are increased up to 70 iu/L
3. Platelets count less than 100× 109
4. High serum uric acid
Treatment
The only suitable way for treatment is delivery and management of the case will depend on severity of pre-eclampsia.
For treatment, antihypertensive drugs are necessary to decrease the risk of hemorrhage or acute pulmonary edema. . Nicardipine, labetalol, clonidine, and dihydralazine are the main antihypertensive drugs prescribed for first line treatment. Corticosteroids are taken to reduce the risk of neonatal mortality and intra-vnetricular hemorrhage. For second line treatment, magnesium sulfate is recommended in convulsion treatment. Also, diuretics are added to antihypertensive drugs such as furosemides (Yellon,
2010).
Prevention
It based on the risk factors such as genetic risk factors, family history of pre- eclampsia, immunologic factors and demographic factors such as a maternal age >35 to predict pre-eclampsia early and easily deal with it before taken any medications. Doctors usually advice to rest and reduce any physical activities, sometimes bed rest is recommended for fetal surveillance calcium and vitamin D supplements are required, low dose acetylsalicylic acid for high risk pregnant women, magnesium sulfate intake, antihypertensive drugs in case of hypertension to avoid development of pre-ecalmpsia and heparin in case of thrombophilia complication (Uzan, 2011).