Preeclampsia

Preeclampsia is a pregnancy-specific condition of increased blood pressure accompanied by proteinuria, edema, or both. The incidence of preeclampsia has been reported as ranging from 2.5% to 7%. Risk factors for the development of preeclampsia include young maternal age, previous preeclampsia, twin pregnancy, chronic hypertension, diabetes mellitus, and hydatidiform mole. Vasospasm is considered central to the pathologic changes of preeclampsia, and the data suggest that this process is triggered by an imbalance between prostacyclin (prostaglandin I2) and thromboxane Ax, biologically active metabolites of arachidonic acid. Preeclampsia has a wide clinical spectrum ranging from mild to severe forms and, potentially, eclampsia with symptoms occurring primarily with severe disease. Preventive strategies under investigation include calcium supplementation and low-dose aspirin supplementation. Prenatal screening, monitoring, and management of preeclampsia are presented.