PRE ECLAMPSITA IN ENGLISH
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PRE ECLAMPSIA-
Hypertensive
disorders of pregnancy-
q
Gestational
hypertension
q
Pre
Eclampsia
q
Chronic
hypertension
q
PreEclampsia
superimposed on chronic hypertension
q
Eclampsia
Pre-eclampsia is an idiopathic condition of pregnancy characterized by
proteinuria and hypertension (>140/90 mmHg) presenting after 20 weeks of
pregnancy in a woman who
previously had normal blood pressure.
Preeclampsia is defined as new onset of hypertension (≥140/90 mmHg) and
proteinuria which occurs after 20 weeks of gestation in previously normotensive
woman
CLINICAL MANIFESTATIONS-
• blood pressure: systolic >140 mmHg or diastolic >90 mmHg
• proteinuria
• edema – may be detectable on examination.
-Ankle edema initially and than more
generalized edema that pits on
pressure .
-Edema is seen on pre-tibial surface, face, hands, abdomen and sacrum.
CAUSES AND RISK FACTORS
Pre-eclampsia is an idiopathic condition Risk factors includes-
• Maternal age (<20 and >40 years)
• Family history of pre-eclampsia
• Pre-eclampsia in a previous pregnancy
• Pregnancy after assisted reproductive technology
• Obesity
• Pre-existing diabetes mellitus type 1
• Pre-existing hypertensive
disease
• Pre-existing medical conditions, e.g. renal disease,
systemic lupus erythematosus (SLE), rheumatoid
Arthritis
• Developing a medical disorder during pregnancy,
e.g. venous thromboembolic disease (VTE), such as
antiphospholipid (Hughes) syndrome (APS),
gestational diabetes, gestational hypertension
• First pregnancy
• Multiple pregnancy
• Developing infection with inflammatory response
• Hydropic degeneration of the placenta
DIAGNOSTIC INVESTIGATIONS-
• Urine examination for protein
-Urine sample or 24 hour urine collection to quantify the proteinuria
(>300 mg) and determine the ratio of protein to creatinine (>30 mg/mmol).
• Complete blood count
• Serum electrolytes
• Liver function test
• Serum Urea and Creatinine
• Ultrasound
• Doppler velocimetry
MANAGEMENT-
• Anti-hypertensives such as methyldopa
and nifedipine.
•In severe case hospital admission may be required with IV
antihypertensive drugs.
• Magnesium sulphate prophylaxis may be added.
• expedite the birth of the baby and placenta.
• Induction of labour will be determined by the
obstetrician, and is likely to be at 37 weeks for mild preeclampsia 34–36
weeks for moderate pre-eclampsia and at 34 weeks for severe hypertension.
• Birth should be earlier in the event of uncontrolled blood pressure or
fetal or antenatal complications, with caesarean section.
NURSING MANAGEMENT-
•
Nursing
assesment including detailed history taking
•
Frequent
BP monitoring as per order
•
Assessment
of Urine output & reflexes
•
Fetal
heart rate monitoring to assess fetal distress
•
Should
administer prescribed drugs on time
•
Maintain
fluid balance oral or IV as per order
•
Observe
for seizures
•
Provide
psychological support
Provide health education to patient and family about-
•
disease
& warning signs
•
Diet:
low salt, adequate protein and
•
Importance
of regular ANC check-ups
