Pre-eclampsia – A multisystem disorder of unknown etiology, develops after 20 weeks of gestation With BP readings ≥ 140/ 90mm Hg , two readings 4 – 6 hours apart with Proteinuria – Urine dipstick for protein : ≥ 2+ or 24 hour urine albumin ≥ 300 mg.
Risk Factors:
- Primigravida,
- multifetal gestation- twins, triplets
- family history of pre-eclampsia ,
- h/o raised BP in previous pregnancy
- Obesity
Warning Signs:
- Headache
- blurring of vision
- epigastric pain
- nausea
- vomiting
- dizziness
- excessive swelling over feet and abdomen
- shortness of breadth
Tests:
- Urine test for protein, Blood investigations- CBC, Coagulation profile, LFT, RFT,LDH
- Fetal monitoring- is done by regular USG to rule out IUGR
Treatment:
- Antihypertensives- Lobetolol, Methyldopa,
- Rest, Diet- low salt, high protein
- Prophylactic Magnesium sulphate and delivery
Complications: of pre-eclamsia are- Eclampsia, antepartum haemorrhage, preterm labour, preterm delivery , HELLP syndrome, cerebral haemorrhage, liver failure and kidney failure
Prevention:
- Prediction of preeclapisa is done by Uterine artery doppler- PI done at 11-14 weeks and Serum sFlt–1 (soluble fms like tyrosin kinase 1)/ PlGF levels, if <38- Pre-eclampsia is less likely
- Prevention of pre-eclampsia- Use little or no added salt in your meals, Drink 6-8 glasses of water a day, Avoid fried foods and junk food, Get enough rest, Exercise regularly, Avoid alcohol, Avoid beverages containing high amount of caffeine, Take calcium rich diet
