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Preeclampsia and Eclampsia (Toxemia of Pregnancy)

Jessica Marabella, MD Reviewed 06/2018
 


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 progr...

DIAGNOSIS

  • Preeclampsia diagnosis:

    • New-onset elevated BP: SBP ≥140 mm Hg or DBP ≥90 mm Hg (on two occasions at least 4 hours apart) or ≥160/110 mm Hg after 20 weeks of gestation (within a shorter inte...

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:

      • Patie...

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; for the Task Force on Hypertension in Pregnancy. Hypertension in pregnancy. Report of the American College of Obstetricians and Gynecol...

ADDITIONAL READING

  • American College of Obstetricians and Gynecologists. ACOG committee opinion no. 560: medically indicated late-preterm and early-term deliveries. Obstet Gynecol.  2013;121(4):90...

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.

  • Diagnosis no longer requires presence of proteinuria.

  • Low-dose ASA starting in early pre...

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