Preeclampsia

Preeclampsia is a hypertensive syndrome that occurs in pregnant women, most often after 20 weeks' gestation, which consists of new-onset, persistent hypertension with either proteinuria or evidence of systemic involvement.

All pregnant women presenting with hypertension and either proteinuria or evidence of systemic involvement require close assessment and monitoring for preeclampsia and its complications.

Delivery is the definitive treatment; the decision about when and how to deliver should only be made after a thorough assessment of the risk and benefits to the mother and baby.

Other mainstays of management include antihypertensive therapy, seizure control, and fluid restriction.

Maternal mortality is highest after delivery, so vigilance should be maintained in the postpartum period.

Preeclampsia can occur in subsequent pregnancies; therefore, women should be counseled about the risk.

Preeclampsia is a disorder of pregnancy that is associated with new-onset hypertension (defined as a systolic blood pressure ≥140 mmHg and/or a diastolic blood pressure ≥90 mmHg), most often after 20 weeks' gestation and frequently near term. Although often accompanied by new-onset proteinuria, hypertension and other signs or symptoms of preeclampsia may present in the absence of proteinuria in some women.[1]American College of Obstetricians and Gynecologists. Gestational hypertension and preeclampsia: ACOG practice bulletin, number 222. Obstet Gynecol. 2020 Jun;135(6):e237-60. https://journals.lww.com/greenjournal/Fulltext/2020/06000/Gestational_Hypertension_and_Preeclampsia__ACOG.46.aspx http://www.ncbi.nlm.nih.gov/pubmed/32443079?tool=bestpractice.com

HELLP syndrome is a subtype of severe preeclampsia characterized by hemolysis (H), elevated liver enzymes (EL), and low platelets (LP). The diagnosis and management of HELLP syndrome is not discussed in detail in this topic (see our topic on HELLP syndrome for more information).