Preeclampsia

Excerpt

Preeclampsia is a hypertensive disorder in pregnancy related to 2% to 8% of pregnancy-related complications worldwide. It results in 9% to 26% of maternal deaths in low-income countries and 16% in high-income countries. Preeclampsia is defined as new-onset hypertension. The parameters for initial identification of preeclampsia are specifically defined as a 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; or shorter interval timing of systolic blood pressure of 160 mm Hg or more or diastolic blood pressure of 110 mm Hg or more, all of which must be identified after 20 weeks of gestation.

The initial presentation of preeclampsia typically arises in near-term pregnancies. Other significant findings that may or may not be a part of the clinical presentation include proteinuria, signs of end-organ damage, such as thrombocytopenia, impaired liver function, severe persistent right upper quadrant or epigastric pain, excluding all other alternative diagnoses, new-onset headache unresponsive to all forms of management, pulmonary edema, or renal insufficiency with abnormal lab values. Further distinguishing subcategories of preeclampsia include classification into mild or severe, which are deemed so based upon presentation and clinical criteria, to be described further.