Preeclampsia is characterized by increased blood pressure
during pregnancy. Preeclampsia is a disease characterized by high blood
pressure, hand foot and swelling (edema), excess protein excretion in urine.
Preeclampsia
is divided into two as mild and severe:
In mild preeclampsia, blood pressure is 140/90 mmHg or above.
While urinary protein excretion is less in mild preeclampsia (more than 300 mg
per day), in severe preeclampsia, more than 2 grams of protein per day is
excreted in the urine. Tension is above 160/110 mmHg in severe preeclampsia. In
addition to this, findings such as excess protein excretion in urine
(albuminuria), elevated liver function tests, decreased platelet count,
permanent headache, visual impairment, and pain in the liver area can be added.
Preeclampsia can cause seizures similar to epileptic seizures
during pregnancy, this is called eclampsia.
The most important point in the diagnosis and follow-up of
preeclampsia is to carefully measure blood pressure. In mild preeclampsia)
blood pressure, i.e. blood pressure is above 140/90 mmHg. In severe
preeclampsia, it is over 160/110 mmHg. In addition to blood pressure
measurement, urinalysis, protein (albumin) level in urine, blood tests
(especially liver and kidney function tests), eye examination are applied in
diagnosis and follow-up.
Who gets
preeclampsia more often? (Risk factors)
The following conditions increase the risk of preeclampsia in
a pregnant woman.
- First pregnancy (nulliparity)
- Advanced maternal age (over 35)
- A history of preeclampsia in previous pregnancy
- A history of hypertension before pregnancy, chronic
hypertension
- Family history of preeclampsia
- Bad obstetric history (infant death in the womb during
previous pregnancies, developmental retardation, detachment, etc.)
- Multiple pregnancy (Twin, triplet) pregnancy
- Type 1 Diabetes
- Kidney disease
- Obesity
- Immune system disorders
- Thrombophilia (coagulation disorders), Factor-5 Leiden
mutation
- Antiphospholipid antibody syndrome
- Mol hydatiform
- Kidney disease in the mother
How common
is preeclampsia?
Preeclampsia is a common disease seen in 5-10% of all
pregnancies. About three quarters of preeclampsia cases are mild and one fourth
are severe.
Changes in
mother during preeclampsia pregnancies:
The classic pathological lesion in the kidney is
gelomerulocapillary endotheliosis.
- The earliest disrupted laboratory finding is an increase in
plasma uric acid level, but it is not used as a diagnostic criterion.
- Plasma creatinine level increases.
- Proteinuria occurs.
- Glomerular filtration rate (GFR), which increases by about
50 percent in pregnancy, decreases in preeclamptic pregnants, kidney blood flow
decreases.
- Thrombocytopenia
- Microangiopathic hemolytic anemia: If excessive hemolysis
occurs, the level of hemoglobinemia, hemoglobinuria, hyperbilirubinemia and
haptaglobulin is observed.
- HELLP syndrome may develop.
- Cardiac afterload increases due to hypertension.
- Intravascular fluid decreases and fluid passes into the
extravascular area, so the cardiac preload decreases.
- Extracellular fluid amount increases
Plasma oncotic pressure decreases
- Cardiac output decreases (normally increases during
pregnancy).
- Hemoconcentration occurs.
- Blood volume decreases, so preeclamptic pregnant women can
tolerate blood loss less.
- Periportal hemorrhage may be observed in the liver. If
HELLP syndrome develops, subcapsular hematoma and rupture may occur.
- Visual impairment (blurred vision, diplopia)
- Uteroplacental insufficiency, detachment placenta
- The risk of IUGR in the baby, perinatal mortality,
morbidity increases.
ADDITIONAL
INFORMATION:
Preeclampsia is not directly related to young age, it is
directly related to advanced maternal age. The reason for its prevalence at a
young age is due to its "first pregnancy". The first pregnancy is a
risk factor directly related to preeclampsia.
-CHEMOTHERAPY AND RADIOTHERAPY IN PREGNANCY
-HEADACHE AND MIGRAINE IN PREGNANCY
-MYOMA IN PREGNANCY
-ROMATOID ARTHRITIS IN PREGNANCY
-GALLBLADDER INFLAMMATION IN PREGNANCY
-GALLSTONE IN PREGNANCY
