Pre-eclampsia history and symptoms
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ogheneochuko Ajari, MB.BS, MS [2]
Diagnosis
- Diagnostic Criteria
The diagnosis of preeclampsia is made when at least two of the following three diagnostic criteria are met:[1]
- Blood pressure
- Systolic blood pressure of 140 mm Hg or more or diastolic blood pressure of 90 mm Hg or more on two occasions at least 4 hours apart after 20 weeks of gestation in a woman with a previously normal blood pressure
- Systolic blood pressure of 160 mm Hg or more or diastolic blood pressure of 110 mm Hg or more.
- Proteinuria
- 300 mg or more per 24-hour urine collection or Protein/creatinine ratio of 0.3 mg/dL or more or Dipstick of 2+
- Or in the absence of proteinuria, new-onset hypertension with the new onset of any of the following:
- Thrombocytopenia: Platelet count< 100,000/dl
- Renal insufficiency: Serum creatinine>1.1 mg/dL or a doubling of the serum creatinine concentration in the absence of other renal disease
- Impaired liver function: Elevated blood level of liver transaminases to twice normal level
- Pulmonary edema
- Intractable headache or visual symptoms
History and Symptoms
History and Symptoms [Disease name] is usually asymptomatic. Symptoms of [disease name] may include the following: [symptom 1] [symptom 2] [symptom 3] [symptom 4] [symptom 5] [symptom 6]
- According to the new guideline, every hypertensive pregnant woman after 20 weeks, should be evaluated for preeclampsia by investigation about multiple organ involvement, even in the absence of proteinuria. [2]
- Preeclampsia can deteriorate rapidly without any specific symptoms.
- Preeclampsia may present the first time intrapartum or early postpartum.
[Preeclampsia
Pre-eclampsia is usually asymptomatic, hence its detection depends on signs or investigations. Nonetheless, one symptom is crucially important because it is so often misinterpreted. The epigastric pain, which reflects hepatic involvement and is typical of the HELLP syndrome, may easily be confused with heartburn, a very common problem of pregnancy. However, it is not burning in quality, does not spread upwards towards the throat, is associated with hepatic tenderness, may radiate through to the back, and is not relieved by giving antacids. It is often very severe, described by sufferers as the worst pain that they have ever experienced. Affected women are not uncommonly referred to general surgeons as suffering from an acute abdomen, for example acute cholecystitis.
In general, none of the signs of pre-eclampsia is specific; even convulsions in pregnancy are more likely to have causes other than eclampsia in modern practice. Diagnosis, therefore, depends on finding a coincidence of several pre-eclamptic features, the final proof being their regression after delivery.
References
- ↑ "Gestational Hypertension and Preeclampsia". Obstetrics & Gynecology. 135 (6): e237–e260. 2020. doi:10.1097/AOG.0000000000003891. ISSN 0029-7844.
- ↑ Brown, Mark A.; Magee, Laura A.; Kenny, Louise C.; Karumanchi, S. Ananth; McCarthy, Fergus P.; Saito, Shigeru; Hall, David R.; Warren, Charlotte E.; Adoyi, Gloria; Ishaku, Salisu (2018). "Hypertensive Disorders of Pregnancy". Hypertension. 72 (1): 24–43. doi:10.1161/HYPERTENSIONAHA.117.10803. ISSN 0194-911X.