Preclampsia

INTRODUCTION

Pre-eclampsia is a devastating condition that affects thousands of women each year.

It is characterized by the new onset of hypertension and proteinuria after 20 weeks of gestation. The hypertensive component of the disease is present when systolic blood pressure is greater than 140 mmHg or the diastolic blood pressure is greater than 90 mmHg in a woman known to be normotensive prior to pregnancy. The diagnosis requires 2 such abnormal blood pressure measurements recorded at least 6 hours apart, but no more than 7 days apart. Proteinuria is present when the urinary protein concentration is greater than 300 mg during a 24-hour period. The 24-hour urine collection is the definitive test to diagnose proteinuria. However, if it is unavailable, a concentration of at least 30 mg/dL (at least 1+ on dipstick testing) in at least 2 random urine samples collected at least 6 hours apart may be used. Pre-eclampsia can be classified as being severe, moderate and mild. It is considered severe when systolic blood pressure is at least 160 mmHg and/or diastolic at least 110 mmHg. Severe proteinuria is defined as protein excretion of at least 5 g per 24 hour period. Dipstick values should not be used to diagnose severe proteinuria. In addition, pre-eclampsia is also considered severe in the presence of multiorgan involvement

[1].

The clinical manifestations of pre-eclampsia are the result of microangiopathy of target organs [2] and include edema, visual disturbances, headache, epigastric pain, thrombocytopenia and abnormal liver function [1].

Numerous articles have been published and are continuing to be published that addresses different aspects of pre-eclampsia. Unfortunately, there has been little progress in predicting and preventing the disorder compared to advances made in treating other serious medical conditions despite multiple