Pre-Eclampsia and Eclampsia

Question 1

What is pre-eclampsia?

Answer 1

It is a placental condition which affects women over 20 weeks of gestation and can present up to 6 weeks after delivery.
It is NEW onset hypertension and proteinuria.

Question 2

What is eclampsia?

Answer 2

Is is pre-eclampsia (Hypertension and proteinuria) with the presence of seizures)

Question 3

What are other signs of pre-eclampsia?

Answer 3

Right Upper quadrant pain
Peripheral oedema
confusion
blurred sight 
pulmonary oedema - SOB and cough
Cerebral oedema

Question 4

What are risk factors of pre-eclampsia?

Answer 4

Family history 
first pregnancy
multiple gestation
>35 yrs 
hypertension
diabetes
obesity
history of pre-eclampsia
autoimmune disease
renal disease

Question 5

What is the cause/pathophysiology of pre-eclampsia?

Answer 5

When the spiral arteries of the placenta don’t dilate and allow more blood to the foetus, so inflammatory enzymes are released - leading to vasoconstriction and sodium retention - causing hypertension.

Question 6

What are the risks to the baby of pre-eclampsia?

Answer 6

Intra-uterine growth restriction
early delivery
foetal death

Question 7

What are the maternal complications of pre-eclampsia?

Answer 7

Eclampsia
HELLP
Dissemminated intravascular coagulation
organ failure

Question 8

What is HELLP?

Answer 8

Haemolysis
Elevated liver enzymes
Low platelets

Question 9

What is the treatment for pre-eclampsia?

Answer 9

The only curative treatment is delivery of the baby and delivery of the placenta.
Antihypertensives - first line is labetelol

If it occurs after delivery - treat symptomatically until symptoms improve.

Question 10

What is the treatment for eclampsia?

Answer 10

Magnesium sulphate