From the Research
Workup for Severe Edema at 19 Weeks of Gestation
The workup for severe edema at 19 weeks of gestation may involve the following:
- Physical examination
- Laboratory evaluations including:
- Full blood count
- Liver function tests
- Electrolytes
- Renal function tests
- Screening for glomerular-based disease
- 24-h urine collection for total protein
- Analysis of serum anti-angiogenic and angiogenic factors
- Fetal ultrasonography
- Placental Doppler examination 1
Differential Diagnosis
Severe edema at 19 weeks of gestation can be a symptom of various conditions, including:
- Preeclampsia
- Nephrotic syndrome
- Renal insufficiency
- Congenital chylothorax
- Mirror syndrome
- Glomerular endotheliosis
Management
Management of severe edema at 19 weeks of gestation may involve:
- Treatment of underlying conditions, such as hypertension with labetalol and edema with furosemide 1
- Fetal therapy, such as intrapleural injection of OK-432 for congenital chylothorax 2
- Delivery, in cases of mirror syndrome or other severe fetal conditions 3
Important Considerations
It is essential to note that edema is a common symptom in pregnancy, and its detection is not clinically useful for diagnosing pre-eclampsia 4. Additionally, the use of diuretics in obstetric practice should be restricted to the management of pulmonary edema in pre-eclampsia 4.