Pregnancy: Preeclampsia and Eclampsia

  • Medical Author:
    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

  • Medical Editor: Charles Patrick Davis, MD, PhD
    Charles Patrick Davis, MD, PhD

    Charles Patrick Davis, MD, PhD

    Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

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Blood Pressure Guidelines

Medical Author: Benjamin C. Wedro, MD, FACEP, FAAEM
Medical Editor: William C. Shiel Jr., MD, FACP, FACR

The concept of blood pressure is sometimes difficult to understand because it is usually described with numbers. However, adequate pressure within arteries is important to allow blood to be pumped throughout the body to deliver oxygen and other nutrients to areas of the body. This allows for normal metabolism and organ function.

The blood pressure recording, measures pressures within the arteries at two different times. The first reading, the systolic pressure, measures the pressure when the heart is pumping blood to the body through the arteries. The second reading, the diastolic pressure, measures the pressure within the arteries when the heart is receiving blood returning from the body.

There needs to be an underlying pressure within arterial blood vessels regardless of whether the heart is pumping or not. This intrinsic pressure is maintained by smooth muscle cells that surround all artery walls, great and small, and in effect squeeze and support the walls. Without this wall support, arteries would collapse in diastole (between each heart beat).

Blood pressure measurement is listed with two numbers with normal being less than 120/80, with 120 being the systolic blood pressure when the heart is pushing blood through the arterial system; and 80 being the diastolic blood pressure when the arteries are at rest and the heart is refilling.

Preeclampsia and eclampsia facts

  • Preeclampsia is a condition of pregnancy characterized by high blood pressure (hypertension) and protein in the urine (proteinuria).
  • Preeclampsia usually occurs after the 34th week of gestation, but it can develop after the infant is delivered.
  • Preeclampsia and eclampsia develop most commonly during the first pregnancy. Pregnant teens and women over 40 are at increased risk.
  • Eclampsia is the development of seizures in a woman with severe preeclampsia. It has a 2% mortality (death) rate.
  • There is no cure for preeclampsia beside delivery of the baby.
  • Women with mild preeclampsia may be monitored closely to allow the baby to mature. They may be given corticosteroids to help the baby's lungs mature and magnesium sulfate to prevent seizures. Sometimes, medications to lower blood pressure are needed.
  • Fetal complications of preeclampsia include the risk of preterm delivery, oligohydramnios (low fluid volume within the uterus), and sub-optimal fetal growth.
  • Maternal complications of preeclampsia and eclampsia include liver and kidney failure, bleeding and clotting disorders, and HELLP syndrome.
  • There is no known way to prevent preeclampsia.
  • The exact cause of preeclampsia is not known, although both genetic (inherited) and environmental factors are likely to be involved.

What are preeclampsia and eclampsia?

Preeclampsia is a condition that can develop during pregnancy characterized by high blood pressure (hypertension) and protein in the urine (proteinuria). If not properly recognized and managed, preeclampsia can progress to eclampsia, which involves the development of seizures in a woman with preeclampsia. Eclampsia can be serious for both mother and baby and can even be fatal. Preeclampsia was formerly known as toxemia of pregnancy. Without treatment, it has been estimated that 1 out of 200 cases of preeclampsia progress to seizures (eclampsia). Estimates of the incidence of preeclampsia range from 2% to 6% in healthy women who have never before given birth.

Preeclampsia occurs after the 20th week of pregnancy and can occur during the days following birth. Some reports describe preeclampsia as occurring up to 4 to 6 weeks after birth, although most cases of postpartum preeclampsia occur within 48 hours of delivery. Ninety percent of cases occur after the 34th week of gestation, and 5% occur after birth.

Preeclampsia and eclampsia are most common in first-time pregnancies. Pregnant teens and women over 40 are also at increased risk.

Medically Reviewed by a Doctor on 11/12/2015

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