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Preeclampsia and Eclampsia (Toxemia of Pregnancy)

Ann M. Aring, FAAFP, MD Reviewed 06/2022
 


BASICS

DESCRIPTION

  • Preeclampsia:

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

      • May progress ...

DIAGNOSIS

Preeclampsia diagnosis: 
  • Blood pressure:

    • 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...

TREATMENT

GENERAL MEASURES

  • Preeclampsia without severe features:

    • Outpatient care

    • Maternal: daily home BP monitoring; daily weights; weekly labs (CBC, creatinine, liver function test [LFT])

    • Fetal:

      • Patient-m...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • Without severe features: restricted activity and close monitoring; with severe features: restricted activity, in hospital

  • Women with a history of preeclampsia shou...

REFERENCES

1
Rolnik DL, Wright D, Poon LC, et al. Aspirin versus placebo in pregnancies at high risk for preterm preeclampsia. N Engl J Med. 2017;377:613-622.
2
Leeman  L, Dresang ...

ADDITIONAL READING

  • Abalos E, Duley L, Steyn DW. Antihypertensive drug therapy for mild to moderate hypertension during pregnancy. Cochrane Database Syst Rev.  2014;(2):...

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 treatment of choice for women demonstrating preeclampsia with ...

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