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Pre-eclampsia affects 2–8% of pregnancies worldwide. [4] [17] [12] Hypertensive disorders of pregnancy (which include pre-eclampsia) are one of the most common causes of death due to pregnancy. [6] They resulted in 46,900 deaths in 2015. [7] Pre-eclampsia usually occurs after 32 weeks; however, if it occurs earlier it is associated with worse ...
The pathogenesis of pre-eclampsia is poorly understood and may be attributed to factors related to the woman and placenta since pre-eclampsia is seen in molar pregnancies absent of a fetus or fetal tissue. [46] The placenta normally produces the potent vasodilator adrenomedullin but it is reduced in pre-eclampsia and eclampsia. [47]
Preeclampsia superimposed on chronic hypertension occurs when a pregnant woman with chronic hypertension develops signs of pre-eclampsia, typically defined as new onset of proteinuria ≥30 mg/dL (1+ in the dipstick) in at least 2 random urine specimens that were collected ≥4 h apart (but within a 7-day interval) or 0.3 g in a 24-h period. [19]
This changes them from high-resistance low-flow vessels into large dilated vessels that provide good perfusion, and oxygenation to the developing placenta. When invasion is shallow it is inadequate, the arteries remain narrow at their openings into the intervillous space, and is the cause of pre-eclampsia, fetal growth restriction and still birth.
Severe pre-eclampsia involves a BP over 160/110 (with additional signs). It affects 5–8% of pregnancies. [20] Eclampsia – seizures in a pre-eclamptic patient, affect around 1.4% of pregnancies. [21] Gestational hypertension can develop after 20 weeks but has no other symptoms, and later rights itself, but it can develop into pre-eclampsia. [22]
Risk factors include smoking, pre-eclampsia, prior abruption (most important and predictive risk factor), trauma during pregnancy, cocaine use, and previous cesarean section. [2] [1] Diagnosis is based on symptoms and supported by ultrasound. [1] It is classified as a complication of pregnancy. [1]
Image credits: Todd Whiteaker #2 Benji. A group of neighbors teamed up to save a giant dog who was dumped by his family into the streets. Despite his huge size, the dog looked scared and was ...
Being or becoming overweight in pregnancy increases the risk of complications for mother and fetus, including cesarean section, gestational hypertension, pre-eclampsia, macrosomia and shoulder dystocia. [101] Excessive weight gain can make losing weight after the pregnancy difficult. [101] [105] Some of these complications are risk factors for ...