PREECLAMPSIA Preeclampsia a serious hypertensive disorder of pregnancy. It is characterized by high blood pressure and organ damage. Preeclampsia affects 5-8% of all pregnancies and is a leading cause of maternal and fetal mortality worldwide. Importantly, preeclampsia is a significant risk factor for future cardiovascular disease in women.
DIAGNOSIS Based on current guidelines (2014) from the Society of Obstetricians and Gynaecologists of Canada, preeclampsia is diagnosed based on the following criteria: Hypertension (blood pressure greater than 140/90mmHg) present before pregnancy or developing after 20 weeks of pregnancy AND one or more adverse features: Maternal signs and symptoms Nausea or vomiting Right upper abdomen pain Persistent headache Chest pain Difficulty breathing
Abnormal laboratory values Proteinuria Elevated liver enzymes Low plasma albumin Decreased oxygen levels Increased white blood cells
Increased clotting time Low platelet count Increased serum uric acid Increased serum creatinine
There are different presentations of preeclampsia. For example, some women may not have any symptoms while some may have symptoms but no proteinuria. Also, HELLP syndrome (hemolysis, elevated liver enzymes, low platelets) can arise without hypertension.
RISK FACTORS Women are at increased risk of preeclampsia if they have any of the following: Preeclampsia in a previous pregnancy Chronic kidney disease Autoimmune disease (e.g. lupus) Type 1 or 2 diabetes Chronic hypertension In vitro fertilization with donor gametes
First pregnancy Age 40 yers or older More than 10 years between pregnancies BMI 35 kg/m2 or more Family history of preeclampsia Pregnant with more than one baby
It is important to know that preeclampsia can happen in women without any known risk factors.