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Preeclampsia and Eclampsia

Overview :

Blood pressure is a measurement of the pressure of blood on the walls of blood vessels called arteries. The arteries deliver blood from the heart to all of the tissues in the body. Blood pressure is reported as two numbers. For example, a normal blood pressure is reported as 110/70 mm Hg (read as 110 over 70 millimeters of mercury; or just 110 over 70). These two numbers represent two measurements, the systolic pressure and the diastolic pressure. The systolic pressure (the first number in the example; 110/70 mm Hg) measures the peak pressure of the blood against the artery walls. This higher pressure occurs as blood is being pumped out of the heart and into the circulatory system. The pumping chambers of the heart (ventricles) squeeze to force the blood out of the heart. The diastolic pressure (the second number in the example 110/70 mm Hg) measures the pressure, during the filling of the ventricles. At this point, the atria contract to fill the ventricles. Because the ventricles are relatively relaaxed, and are not pumping blood into the arteries, pressure in the arteries is lower as well.

High blood pressure in pregnancy (hypertension) is a very serious complication. It puts both the mother and the fetus (developing baby) at risk for a number of problems. Hypertension can exist in several different forms:

  • The preeclampsia-eclampsia continuum (also called pregnancy-induced hypertension or PIH). In this type of hypertension, high blood pressure is first noted sometime after week 20 of pregnancy and is accompanied by protein in the urine and swelling.
  • Chronic hypertension. This type of hypertension usually exists before pregnancy or may develop before week 20 of pregnancy.
  • Chronic hypertension with superimposed preeclampsia. This syndrome occurs when a woman with pre-existing chronic hypertension begins to have protein in the urine after week 20 of pregnancy.
  • Late hypertension. This is a form of high blood pressure occurring after week 20 of pregnancy and is unaccompanied by protein in the urine and does not progress the way preeclampsia-eclampsia does.

Preeclampsia is most common among women who have never given birth to a baby (called nulliparas). About 7% of all nulliparas develop preeclampsia. The disease is most common in mothers under the age of 20, or over the age of 35. African-American women have higher rates of preeclampsia than do Caucasian women. Other risk factors include poverty, multiple pregnancies (twins, triplets, etc.), pre-existing chronic hypertension or kidney disease, diabetes, excess amniotic fluid, and a condition of the fetus called nonimmune hydrops. The tendency to develop preeclampsia appears to run in families. The daughters and sisters of women who have had preeclampsia are more likely to develop the condition.

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