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Pre-eclampsia

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VOL: 101, ISSUE: 40, PAGE NO: 27

WHAT IS IT

 

WHAT IS IT
- Pre-eclampsia is the most common of the serious complications of pregnancy.

 

 

- It is potentially life-threatening to both mother and baby.

 

 

- Most deaths resulting from pre-eclampsia have been associated with substandard care due to failure to identify and act on risk factors at antenatal booking and failure to recognise and to act on signs and symptoms from 20 weeks gestation.

 

 

INCIDENCE
- Worldwide between 1.5 and eight million women develop pre-eclampsia every year (Action on Pre-eclampsia, 2004).

 

 

- Between 40,000 and 60,000 women die each year as a result of pre-eclampsia.

 

 

- It has been suggested that the shift towards having children later in life may cause an increase in cases of pre-eclampsia.

 

 

CAUSE
- Although the first case of pre-eclampsia was identified more than 150 years ago, the exact cause is still not understood.

 

 

SIGNS AND SYMPTOMS
- Pre-eclampsia has no symptoms in its early stages and is detectable only by regular antenatal checks.

 

 

- Oedema - although some swelling of the feet and ankles is considered normal during pregnancy.

 

 

- Weight gain of more than 1kg per week or sudden onset, over one to two days.

 

 

- Hypertension.

 

 

- Proteinuria.

 

 

- Headaches.

 

 

- Decreased urine output.

 

 

- Nausea and vomiting.

 

 

- Agitation.

 

 

- Vision changes (flashing lights in the eyes).

 

 

MANAGEMENT
- The only cure for pre-eclampsia is to deliver the baby.

 

 

- If delivery would result in a very premature baby, the condition may be managed by bedrest and close monitoring, with delivery as soon as the baby has a good chance of surviving.

 

 

- It is important for all pregnant women to have early and ongoing antenatal care to allow early diagnosis and management of pre-eclampsia.

 

 

- Action on Pre-eclampsia is a UK-based charity that can provide support to women worldwide.

 

 

RISK FACTORS
- First-time mothers.

 

 

- Women over 40.

 

 

- A BMI over 35.

 

 

- Family history of pre-eclampsia.

 

 

- A last pregnancy 10 or more years ago.

 

 

- Hypertension.

 

 

- Diabetes.

 

 

- Kidney disease;

 

 

- A multiple pregnancy;

 

 

- Previous pre-eclampsia.

 

 

COMPLICATIONS
- Undetected or unmanaged pre-eclampsia can develop into eclampsia, in which seizures and coma are experienced.

 

 

- Worldwide approximately 150,000 women have eclamptic convulsions every year.

 

 

- Early delivery for the management of pre-eclampsia may result in complications of prematurity for the baby.

 

 

- Worldwide pre-eclampsia is associated with approximately 4 million growth-restricted babies every year.

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