A serious condition in which hypertension, oedema, and proteinuria develop in the last (3rd) trimester of pregnancy. If severe, symptoms may include headache, nausea and vomiting, abdominal pain, and visual disturbances. The condition, which is sometimes called pre-eclamptic toxaemia or , is more common in 1st pregnancies and if diabetes mellitus, hypertension, or kidney disease is present. Untreated pre-eclampsia may lead to eclampsia. For some cases of pre-eclampsia, treatment is bed-rest and antihypertensive drugs. In late pregnancy, or if severe, induction of labour or caesarean section may be necessary.
A complication of pregnancy (see PREGNANCY AND LABOUR), of unknown cause, which in severe cases may proceed to ECLAMPSIA. It is characterised by HYPERTENSION, renal impairment, OEDEMA, often with PROTEINURIA and disseminated intravascular coagulation. It usually occurs in the second half of pregnancy – mild cases (without proteinuria) occurring in about 10 per cent of pregnancies, severe cases in about 2 per cent. Predisposing factors include a ?rst pregnancy, or pregnancy by a new partner; a family history of pre-eclampsia, hypertension, or other cardiovascular disorders; and preexisting hypertension or DIABETES MELLITUS. Increased incidence with lower socio-economic class may be linked to diet or to failure to attend for antenatal care. Although less common in smokers, fetal outlook is worse. Multiple pregnancy and HYDATIDIFORM MOLE, together with hydrops fetalis (see HAEMOLYTIC DISEASE OF THE NEWBORN), predispose to early and severe pre-eclampsia.
Treatment Severe pre-eclampsia is an emergency, and urgent admission to hospital should be arranged. Treatment should be given to control the hypertension; the fetal heart rate carefully monitored; and in very severe cases urgent CAESAREAN SECTION may be necessary.
n. the combination of *pregnancy-induced hypertension and *proteinuria (>0.3 g in 24 hours) with or without oedema. The condition usually resolves after delivery, but the risk of *eclampsia remains for up to the eleventh day postpartum. See also eclampsia; HELLP syndrome.
Health Encyclopedia