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Preeclampsia and Eclampsia (Toxemia of Pregnancy)

Jessica Marabella, MD and Ann M. Aring, MD, FAAFP Reviewed 06/2019
 


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:

    • 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) or ≥160/110 mm Hg after ...

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
American College of Obstetricians and Gynecologists, Task Force on Hypertension in Pregnancy. Hypertension in pregnancy. Report of the American College of Obstetricians and Gynecologists’ ...

ADDITIONAL READING

  • Abalos E, Duley L, Steyn DW. Antihypertensive drug therapy for mild to moderate hypertension during pregnancy. Cochrane Database Syst Rev.  2014;(2):CD002252. [View Abstract on...

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

  • Diagnosis no longer requires presence of proteinuria.

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

  • Magnesium sulfate is the treatment...

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