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eclampsia/pre-eclampsia (From Greek eklampsis, shining forth) Metabolic toxemia of pregnancy Obstetrics A condition which usually develops in late pregnancy or the immediate puerperium Clinical HTN, hemoconcentration, sodium retention with resultant edema Lab Albuminuria, proteinuria, hypoproteinemia, ↑ nitrogen/BUN; pre-eclampsia is most common in primigravidas, after the 24th gestational wk, but may occur as soon as trophoblastic tissue is present Treatment If mild, bed rest and sedation; if severe, antihypertensives–eg, vasodilators, α methyldopa; if convulsions, magnesium sulfate. See HELLP syndrome.
pre-eclampsia A syndrome of high blood pressure (HYPERTENSION), fluid accumulation in the tissues (OEDEMA) and protein in the urine (albuminuria) that becomes apparent in the second half of pregnancy. Pre-eclampsia is primarily a placental disorder with damage to the inner lining (endothelium) of placental blood vessels. Oxygen FREE RADICALS cause endothelial cell damage, and may lead to reduced NITRIC OXIDE production, so that blood vessel widening (vasodilatation) is interfered with. Pre-eclampsia is a warning of the dangerous complication of ECLAMPSIA-a condition of seizures carrying a high maternal and fetal mortality. A major reason for antenatal care is to monitor for pre-eclampsia and to treat the condition, induce labour or perform a Caesarean section. It has been shown that abnormally high levels of circulating angiogenic factors such as vascular endothelial growth factor and soluble fms-like tyrosine kinase 1 predict the development of pre-eclampsia.