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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]
Magnesium sulfate as a medication is used to treat and prevent low blood magnesium and seizures in women with eclampsia. [1] It is also used in the treatment of torsades de pointes, severe asthma exacerbations, constipation, and barium poisoning. [1] [2] It is given by injection into a vein or muscle as well as by mouth.
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]
Both circulating and placental levels of soluble fms-like tyrosine kinase-1 (sFlt-1) are higher in women with pre-eclampsia than in women with normal pregnancy. [26] sFlt-1 is an anti-angiogenic protein that antagonizes vascular endothelial growth factor (VEGF) and placental growth factor (PIGF), both of which are proangiogenic factors. [15]
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]
[1] [5] 40% of all people with PRES are unwell enough to require intensive care unit admission for close observation and treatment of complications. [3] Those with PRES with seizures are treated using standard anticonvulsants used in other seizure disorders as there are no specific medications specific to PRES with seizures.
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