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Preeclampsia and Eclampsia (Toxemia of Pregnancy)

Ann M. Aring, MD, FAAFP, FASAM Reviewed 04/2024
 


BASICS

DESCRIPTION

  • Preeclampsia: A disorder of pregnancy occurring after 20 weeks’ gestation characterized by new-onset hypertension (HTN), new-onset proteinuria, ± impaired organ function

  • Eclampsia: Ne...

DIAGNOSIS

Preeclampsia diagnosis: 
  • New-onset elevated blood pressure (BP): systolic BP (SBP) ≥140 mm Hg or diastolic BP (DBP) ≥90 mm Hg (on two occasions at least 4 hours apart) after 20 weeks' gestati...

TREATMENT

GENERAL MEASURES

  • Health care providers must balance timing of delivery with maternal and fetal risks.

  • Delivery recommended for pre-eclampsia of any severity at ≥37 weeks' gestation.

  • Preeclampsi...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Women with a history of preeclampsia should report this to physicians caring for them in later life. It is an important cardiovascular disease risk factor. 

DIET

Do...

REFERENCES

1
American College of Obstetricians and Gynecologists. ACOG Committee Opinion No. 767. Emergent therapy for acute-onset, severe hypertension during pregnancy and the postpartum period. Obste...

ADDITIONAL READING

  • Abalos  E, Duley  L, Steyn  DW. Antihypertensive drug therapy for mild to moderate hypertension during pregnancy. Cochrane Database Syst Rev.  2014;(...

CODES

ICD10

  • O14.90 Unspecified pre-eclampsia, unspecified trimester

  • O15.00 Eclampsia in pregnancy, unspecified trimester

  • O14.00 Mild to moderate pre-eclampsia, unspecified trimester

  • O14.10 Severe pre-ecla...

CLINICAL PEARLS

  • Management of preeclampsia depends on both the severity of the condition and the GA of the fetus.

  • Magnesium sulfate is the drug of choice for preeclampsia with severe features.

  • Start da...

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