Management of PreeclampsiaManagement of PreeclampsiaManagement of Preeclampsia

Hospital Physician November 2007 25 P reeclampsia is a syndrome characterized by hypertension and proteinuria that occurs during the second and third trimester of pregnancy. It can cause disseminated intravascular coagulation, vasospasm, sodium retention, and seizures; the occurrence of seizures in a preeclamptic women marks the onset of eclampsia. Preeclampsia is the leading cause of maternal morbidity and mortality worldwide,1 affecting 5% to 7% of first pregnancies and recurring in 13% to 18% of subsequent pregnancies.2,3 Although mortality from preeclampsia and eclampsia is highest in underdeveloped countries, the burden of disease and mortality in developed countries is considerable as well. In the United States, almost 20% of pregnancy-related deaths after 20 weeks’ gestation are attributed to complications from preeclampsia and eclampsia.4 Although preeclampsia currently is a significant clinical problem, its impact is likely to increase as conditions that place a woman at risk for preeclampsia, such as diabetes and obesity, continue to become more prevalent.5 This article reviews the pathophysiology, diagnosis, and management of preeclampsia.