7: Which Pregnancy Complication?

Question 1

Convulsions in a 34-week pregnant woman with a history of preeclampsia and no personal history of seizures.

Answer 1

Eclampsia – A life-threatening complication of preeclampsia characterized by tonic–clonic seizure activity, which may be accompanied by loss of consciousness and intracranial hemorrhage.

Question 2

A 34-week pregnant woman with BP 140/90 and proteinuria of +1 on 2 occasions 4 hours apart or 300mg or greater in 24-hr time frame.

Answer 2

Preeclampsia – Occurs in 6% to 10% of pregnancies and is characterized by a systolic blood pressure of 140 mm Hg or higher, a diastolic blood pressure of 90 mm Hg or higher, and proteinuria of +1 on two occasions 4 hours apart or 300 mg or greater in a 24-hour time frame or absent proteinuria but with the presence of thrombocytopenia, renal insufficiency, impaired liver function, pulmonary edema, or central nervous system or visual changes.

Question 3

A 32-week pregnant woman with B/P of 150/90, with NO protein in her urine but with labs/test results indicating thrombocytopenia, renal insufficiency, impaired liver function and pulmonary edema and with C/O visual changes and mild headache.

Answer 3

Preeclampsia – Occurs in 6% to 10% of pregnancies and is characterized by a systolic blood pressure of 140 mm Hg or higher, a diastolic blood pressure of 90 mm Hg or higher, and proteinuria of +1 on two occasions 4 hours apart or 300 mg or greater in a 24-hour time frame or absent proteinuria but with the presence of thrombocytopenia, renal insufficiency, impaired liver function, pulmonary edema, or central nervous system or visual changes.

Question 4

A 34-week pregnant woman who has preeclampsia (hypertension) and C/O epigastric pain, chest pain and extreme fatigue and with labs indicating hemolysis, elevated liver enzymes and low platelets.

Answer 4

HELLP Syndrome – It is considered to be a serious complication of preeclampsia, although it can also occur without being associated with preeclampsia. This syndrome is characterized by hypertension, elevated liver enzymes, and low platelets. Women with HELLP syndrome may complain of headache, epigastric or chest pain, and extreme fatigue, nausea, and vomiting. The serious risks associated with HELLP syndrome are hepatic rupture, DIC, and eclampsia.