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Pre-eclampsia usually occurs after 32 weeks; however, if it occurs earlier it is associated with worse outcomes. [6] Women who have had pre-eclampsia are at increased risk of high blood pressure, heart disease and stroke later in life. [15] [18] Further, those with pre-eclampsia may have a lower risk of breast cancer. [19]
Eclampsia, like pre-eclampsia, tends to occur more commonly in first pregnancies than subsequent pregnancies. [38] [39] [40] Women who have long term high blood pressure before becoming pregnant have a greater risk of pre-eclampsia. [38] [39] Patients who have gestational hypertension and pre-eclampsia have an increased risk of eclampsia. [41]
Preeclampsia superimposed on chronic hypertension occurs when a pregnant woman with chronic hypertension develops signs of pre-eclampsia, typically defined as new onset of proteinuria ≥30 mg/dL (1+ in the dipstick) in at least 2 random urine specimens that were collected ≥4 h apart (but within a 7-day interval) or 0.3 g in a 24-h period. [19]
The genetic roots of gestational hypertension and pre-eclampsia are certain, as women with a family history of the condition are three times more likely to develop it when they are pregnant. [25] One of the potential causes of gestational hypertension and pre-eclampsia is when the trophoblast does not invade far enough into the uterine lining. [26]
Severe pre-eclampsia involves a BP over 160/110 (with additional signs). It affects 5–8% of pregnancies. [20] Eclampsia – seizures in a pre-eclamptic patient, affect around 1.4% of pregnancies. [21] Gestational hypertension can develop after 20 weeks but has no other symptoms, and later rights itself, but it can develop into pre-eclampsia. [22]
HELLP syndrome occurs in about 0.7% of pregnancies and affects about 15% of women with eclampsia or severe pre-eclampsia. [5] [2] Death of the mother is uncommon (< 1%). [1] [3] Outcomes in the babies are generally related to how premature they are at birth. [1] The syndrome was first named in 1982 by American gynaecologist Louis Weinstein. [2]
Pre-eclampsia is a disease defined by a combination of signs and symptoms that are related to maternal hypertension. [59] The cause is unknown, and markers are being sought to predict its development from the earliest stages of pregnancy. [60] Some unknown factors cause vascular damage in the endothelium, causing hypertension. [61]
Risk factors include smoking, pre-eclampsia, prior abruption (most important and predictive risk factor), trauma during pregnancy, cocaine use, and previous cesarean section. [2] [1] Diagnosis is based on symptoms and supported by ultrasound. [1] It is classified as a complication of pregnancy. [1]