Preeclampsia

00:01 Our topic here is preeclampsia.

00:05 We have dealt with preeclampsia in a number of our topics.

00:09 And the reason for that is because of the signs and symptoms that the pregnant woman is going to exhibit and and really it touches upon a few different places.

00:18 For example, we had mentioned this in nephrology and the reason for that is because the pregnant woman is going to be losing protein in the urine.

00:31 At this juncture, I would not worry about the exact amount, that’s a little controversial, but you definitely know that the pregnant woman is losing protein in her urine.

00:42 If she’s losing urine or if she’s losing protein in the urine, she’s also losing oncotic pressure.

00:48 So now you can imagine that a pregnant woman, usually in her third trimester -- third trimester – is experiencing edema, and there might be greater than expected weight gain for her gestational age.

01:02 What else are you going to find in preeclampsia? There might be hypertension.

01:07 In fact, there is.

01:09 Meaning to say that it could be as high as 160/90.

01:13 This is not good.

01:14 When there is such hypertension taking place and you’re dealing with pregnancy, there’s very possibility that she might have abrupt separation of the placenta from the uterus And we call this what? We call this abruptio placenta.

01:32 Next, proteinuria, edema in third trimester.

01:35 But why do we call this pre-eclampsia? The onset of seizures would mean eclampsia.

01:43 So pre-eclampsia is before the onset of seizures.

01:46 So what does that mean to you as a clinician? You do everything in your power to make sure you prophylactically treat your pregnant woman or you prevent the onset of seizures.

01:57 Once seizures kick in, once again, there might be abruptio placenta.

02:01 In addition, there might be mixing of the fetal placental type of circulation.

02:04 That is not good.

02:05 It may result in amniotic fluid emboli.

02:08 All right, this is some of the basic pathology that you know about.

02:11 And all of these may then result in interesting triggers such as a DIC-like event.

02:17 6% of pregnant women, that is a very high number or percentage.

02:22 If seizures then develop, we call this eclampsia.

02:25 The problem is when seizures kick in, you’re worried about DIC in your pregnant woman.

02:31 My goodness, this is close to death.

02:35 And treatment here, ultimate cure -- Earlier, I told you about prevention and prophylaxis of the seizures and that will come in the form of magnesium sulfate.

02:45 That is not the cure of preeclampia or eclampsia.

02:49 It’s not.

02:50 The cure for pre and eclampsia is actual delivery of the fetus