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Pre-eclampsia affects 2–8% of pregnancies worldwide. [4] [17] [12] Hypertensive disorders of pregnancy (which include pre-eclampsia) are one of the most common causes of death due to pregnancy. [6] They resulted in 46,900 deaths in 2015. [7] Pre-eclampsia usually occurs after 32 weeks; however, if it occurs earlier it is associated with worse ...
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]
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]
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]
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]
[3] [4] While high blood pressure treatment has been shown to decrease the incidence of severe hypertension during pregnancy, there was no significant difference in pregnancy complications (for example, superimposed pre-eclampsia, stillbrith/neonatal death, small for gestational age). [5]
Calcium supplementation in women who have low dietary calcium may reduce the number of negative outcomes including preterm birth, pre-eclampsia, and maternal death. [102] The World Health Organization (WHO) suggests 1.5–2 g of calcium supplements daily, for pregnant women who have low levels of calcium in their diet. [103]