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Our topic here is preeclampsia.
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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.
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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.
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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.
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What else are you going
to find in preeclampsia?
There might be hypertension.
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In fact, there is.
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Meaning to say that it could
be as high as 160/90.
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This is not good.
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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.
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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.
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That is not good.
02:05
It may result in
amniotic fluid emboli.
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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.
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If seizures then develop,
we call this eclampsia.
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The problem is when
seizures kick in,
you’re worried about DIC
in your pregnant woman.
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My goodness,
this is close to death.
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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.
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That is not the cure of
preeclampia or eclampsia.
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It’s not.
02:50
The cure for pre and eclampsia
is actual delivery of the fetus