Pre-eclampsia

The pre-eclampsia (in the past called toxaemia (gravidic) ) is a gravidic arterial Hypertension, i.e. related to the Grossesse. By definition, it is present when an expectant mother reached of gravidic hypertension starts to develop a Protéinurie. Formerly, it was considered that the edema belonged to the Syndrome of pre-eclampsia, but at present both Symptôme S quoted at the beginning are sufficient for the diagnosis of pre-eclampsia .

Epidemiology

Pre-eclampsia is more frequent in the first calf cows (women awaiting their first child), in the patients having a twin pregnancy and begins starting from the third quarters from the pregnancy. The patients suffering from diabetes, arterial Hypertension and Néphropathie have more risk to develop an pre-eclampsia.

Physiopathology of eclampsia

The placenta secretes mediators of the Inflammation who will injure the Endothélium arterial capillaries and vessels, in particular on the level of the Rein S.

Diagnosis

  • systolic arterial Hypertension > 140 mmHg and/or diastolic HTA > 90 mmHg.
  • Protéinurie > 0,5g/24 hours (or > 300mg/liter)
Other signs exist without being essential to the diagnosis:
  • Oliguria
  • Pain of the hypochondre right
  • Thrombopénie
  • Hyperuricémie
  • Edema S of the sloping parts
  • pulmonary Edema
  • sharp ostéo-tendineux Reflexes

In her severe form, the patient presents a severe arterial hypertension (systolic higher than 160mmHG and/or diastolic higher than 110mmHg) with neurosensory disorders such Céphalée S, eye trouble until the renal eclampsia and of the disorder the such Anurie and the chronic Impaired renal function.

Complications

The possible complications are many and serious:

  • retro-placental Éclampsie
  • Hématome
  • HELLP syndrome
  • CIVD (disseminated intravascular coagulation)
  • acute Impaired renal function with in the extreme cases one necroses cortical
  • gravidic acute hepatic Stéatose, hématome under capsulaire of the liver
  • Tableau of cerebral Ischémie: cortical Blindness
  • exsudatif retinal Separation
  • Delay of growth in utéro
  • fetal Death in utero

Treatment

The assumption of responsibility of pre-eclampsia is done in hospital medium. The delivery of the child makes it possible to stop the secretion of the placenta and to stop the evolution of pre-eclampsia towards its neurological, hepatic and renal complications.

While waiting for a compatible term of childbirth between the life of the child and the safeguard of that of the mother, the mom can receive drugs Anti-hypertenseur S under medical supervision in hospital medium.

The Epsom salt in IV makes it possible to limit the appearance of the eclampsia.

See too

Reference

  • Emedicine article one eclampsia
  • " Preeclampsy, gravidic toxaemia, the éclampsie" on '' Doctissimo ''

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