PRE-ECLAMPSIA

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PRE-ECLAMPSIA

  • is a serious condition that causes a sudden increase in blood pressure during pregnancy
  • usually characterized by high blood pressure, protein in the urine and edema
  • generally happens after the 20th week of pregnancy
  • can affect several of the body organs, including the liver, kidney and brain
  • may develop after childbirth, a condition known as postpartum preeclampsia

TYPES
Mild Pre-eclampsia 
  • Mild pre-eclampsia is characterized by a blood pressure of 140/90 mm Hg and high levels of protein in the urine.
Severe Pre-eclampsia
  • People with severe pre-eclampsia manifest the signs of mild pre-eclampsia plus signs of kidney or liver damage, low platelet count, fluid in your lungs, headaches and dizziness, and visual impairment.

CAUSE
The exact cause of pre-eclampsia is unknown but some potential causes are being explored. These includes:
  • genetic factors
  • blood vessel problems
  • autoimmune disorders
  • insufficient blood flow to the uterus

RISK FACTORS
Risk factors associated with preeclampsia include:
  • First pregnancy
  • Multiples pregnancy
  • Personal history of preeclampsia
  • Family history of preeclampsia
  • Being over the age of 40
  • Chronic high blood pressure (hypertension)
  • Type 1 or type 2 diabetes before pregnancy
  • Kidney disease
  • Use of in vitro fertilization

SIGNS AND SYMPTOMS
  • protein in the urine
  • high blood pressure
  • persistent headache
  • upper abdominal pain
  • shortness of breath
  • rapid weight gain
  • nausea and vomiting 
  • urinating less often
  • lower platelet count
  • impaired liver function

COMPLICATIONS
Preeclampsia is a very serious condition. If left untreated, it can be fatal to both the mother and the baby. Complications that may arise include:
  • Eclampsia
  • HELLP syndrome
  • Placental Abruption 
  • Damage to the Liver
  • Cardiovascular Disease
  • Pulmonary Edema
  • Fetal Growth Restriction


DIAGNOSTIC PROCEDURES

Preeclampsia is frequently diagnosed during routine prenatal visits when the healthcare provider examines the blood pressure, weight gain, and urine of a pregnant woman.

If the patient have a high blood pressure, the healthcare provider will order additional tests to check for other signs of preeclampsia, such as:

  • Blood tests
  • Fetal ultrasound
  • Nonstress test or biophysical profile
  • 24-hour urine collection

TREATMENT

If the patient is at 37 weeks or later, delivering the baby is the best treatment for preeclampsia. However, if the patient have preeclampsia before 37 weeks, the healthcare provider may recommend the following medications:

  • Antihypertensive drugs, such as Hydralazine and Labetalol, to lower the blood pressure
  • Anticonvulsant drugs, such as Magnesium Sulfate, to prevent seizures
  • Corticosteroids, such as Dexamethasone, to induce fetal lung maturity to prepare for premature delivery

NURSING MANAGEMENT
  • Monitor vital signs.
  • Monitor fetal heart rate.
  • Check urine for protein at every prenatal visit.
  • Assess for edema of face, arms, hands, legs, ankles, and feet.
  • Assess for signs of abruptio placentae.
  • Assess the weight daily, preferably in the morning before breakfast.
  • Assess deep tendon reflexes.
  • Maintain a quiet environment.
  • Encourage patient to have a bed rest.
  • Support a nutritious diet.
  • Administer medications to prevent eclampsia.

NURSING DIAGNOSIS
  • Decreased Cardiac Output 
  • Risk for Imbalanced Fluid Volume 
  • Ineffective Tissue Perfusion 
  • Risk for Injury 
  • Imbalanced Nutrition: Less Than Body Requirements 
  • Deficient Knowledge

PREVENTION
Preeclampsia is not entirely preventable, but there are several steps a pregnant woman can take to lower the chance of developing preeclampsia. These steps can include:
  • Drink 6-8 glasses of water a day.
  • Get enough sleep/rest. 
  • Exercise regularly.
  • Avoid drinking alcohol and coffee.
  • Avoid eating fried foods and junk food.
  • Eat less salt.
  • Keep feet elevated a few times per day.


REFERENCES:
Herndon, J. (2021, October 27). Preeclampsia: Causes, Diagnosis, and Treatments. Healthline. https://www.healthline.com/health/preeclampsia#symptoms
Preeclampsia. (2021, October 14). Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/17952-preeclampsia#:~:text=Preeclampsia%20can%20be%20categorized%20as,(seen%20in%20blood%20work).
Preeclampsia. (2022, April 15). Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/preeclampsia/diagnosis-treatment/drc-20355751






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