From the Research
Introduction to Preeclampsia
Preeclampsia is a pregnancy-specific syndrome characterized by new-onset hypertension and end-organ dysfunction, often occurring after 20 weeks of gestation 1, 2. It is a leading cause of maternal and perinatal morbidity and mortality worldwide.
Diagnosis of Preeclampsia
The diagnosis of preeclampsia is based on the presence of hypertension and proteinuria, with or without multisystem dysfunction and fetal involvement 2, 3. The American College of Obstetricians and Gynecologists Task Force on Hypertension in Pregnancy has refined the diagnostic criteria for preeclampsia, recognizing it as a complex, progressive, multisystem disorder with a highly variable presentation 4.
Risk Factors for Preeclampsia
Several risk factors have been identified for the development of preeclampsia, including a prior history of preeclampsia, diabetes, kidney disease, obesity, and high maternal age at pregnancy 1, 2. Women with these risk factors should be closely monitored during pregnancy.
Treatment and Management of Preeclampsia
The only known curative treatment for preeclampsia is termination of pregnancy, either through induction of delivery or cesarean section 1, 3. Management before the onset of labor includes close monitoring of maternal and fetal status, as well as seizure prophylaxis with magnesium sulfate and medical management of hypertension if necessary 3. Delivery remains the ultimate treatment for preeclampsia.
Management Options
- Close monitoring of maternal and fetal status
- Seizure prophylaxis with magnesium sulfate
- Medical management of hypertension
- Delivery (induction or cesarean section)
Prevention and Screening
Currently, there is no single reliable, cost-effective screening test for preeclampsia, and there are no well-established measures for primary prevention 3. However, access to prenatal care, early detection of the disorder, careful monitoring, and appropriate management are crucial elements in the prevention of preeclampsia-related deaths.
Long-term Health Implications
Women and fetuses affected by preeclampsia are at higher risk of developing long-term health issues, including cardiovascular disease 2, 5. Physicians providing healthcare to women should recognize potential risk factors that arise from patient obstetric histories and provide optimal long-term health surveillance.