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PRE-ECLAMPSIA DURING PREGNANCY
Presented by :wesam telfah
Supervised by :dr bayan obeidat
PRE-ECLAMPSIA :
Definition :
a disorder associated with pregnancy consisting of
hypertension, proteinuria and new-onset dependent
oedema, most commonly after 20 weeks of
gestation”
ECLAMPSIA
Definition-
“pre eclampsia complicated with seizures”
The preeclampsia stages :
PREECLAMPSIA STAGES :
 Altered placenta
formation
 Reduced utero placental
blood
 Fetal restriction growth
 Oxidative stress
 Inflamation
 Apoptosis
 Structural damage
 Proteinuria elevated
 Hypertyension
 Angio spasm in brain
 Brain edema lead to
sever epileptic
seizures -eclampsia
Stage 1 Stage 2
HELLP SYNDROME
 Undiagnosed pre-eclampsia progresses to cause-
Haemolysis
Elevated Liver enzymes
Low Platelets
NORMAL PLACENTA VER UB NORMAL
MECHANISM OF PLACENTA
DYSFUNCTION:
FEATURING :
 Hypertension :
 systol > 140mmHg
or 30mm above pre-preg
 diastolic > 90 mmHg
or 15mm above pre-preg
 Two abnormal measurements, on two occasions, more
than 6 hours apart
Proteinuria :
 Is defined as 300 mg/day
 Sever form of PE is hemolysis = elevated in liver
enzyme and low platelet syndrome =
( HELLP ) .
EPIDEMIOLOGY :
 Freq (US)
pre-eclampsia: 6-8% of pregnancies
eclampsia: 0.05-0.2%
COMPLICATIONS/PROGNOSIS
 Permanent neuro damage
 Renal insufficiency
 Abruption
 Death
 25% of eclamptics will be so in future
pregnancies
 Increased risk of essential hypertension
MORTALITY/MORBIDITY
 Maternal: 8-36% most frequently related to
seizure activity
 Foetal: 13-30% most frequently related to
iatrogenic prematurity
INVESTIGATION :
 Hypertension
 Urinalysis- proteinuria greater than 3+
 Blood tests
 CT head
SIGNS AND SYMPTOMS :
SYMPTOMS :
 Headache
 Oedema
 Visual disturbance
 Focal neurology, fits, anxiety, amnesia
 Abdominal pain
 low urine output
 Sensitivity of eye to bright light
 None
SIGNS :
 Hypertension
 Tachycardia and tachypnoea
 Creps or wheeze on auscultation
 Neurological deficit
 Hyperreflexia
 Petechiae, intracranial haemorrhage
 Generalised oedema
 Small uterus for dates
RISK FACTORS :
 Low socioeconomic class
 Multiple foetuses, or hydatid
 Maternal age <20 or >35yrs
 Gestational or pre-gestational DM
 Renal disease
 Family history- four times the risk
 Inadequate diet (vit C/E, Ca ,zink ,n-3 FA)
 Homocysteine
 Obesity and over wt
PE FREQ OVER AGE :
RISK FACTOR TO DEVELOPE OF
PREECLAMPSIA WITH INSULIN RESISTANCE:
Pre- pregnancy Pregnancy
Elevated serum insulin ,FFA ,TG Genetic predisposition to HTN
Disrupted platelet function Hormonal and metabolic changed
Renal disease
Nutritional status
OUTCOME OF EXISTENCE OF PE:
Mother Newborn
Early delivery by cesarean
section
Growth restriction
Acute renal dysfunction Respiratory distress dysfunction
Increased risk of GD,HTN,DM
T 2
Rupture of placenta
POTENTIAL PREVENTION :
CALCIUM INFLUENCE :
DRUGS :
P d
R
E i
E
C e
L
A t
M
P
S
I
A
NUTRITION INTERVENTION:
 1000 mg calcium daily = normal blood vessel
 600 mcg folate include 400 mcg folic acid
 Vit C & E (200mg,400 Iu) respectivly
 5 or more serving veg & fruit
 Consumption of low glycemic index
 No restriction of sodium intake
 Moderate exersise
U-TUBE VIDEO ABOUT
PREECLAMPSIA:
 http://www.youtube.com/watch?v=wsS8rxA31jw
 http://www.youtube.com/watch?v=xzw1jhOP5b0
 http://www.youtube.com/watch?v=Ft-_0Bj9NNs
ANY QUSTIONS ?
THANKS …….)
REFERENCES:
REFERENCES:

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