Pre-eclampsia

PRE-ECLAMPSIA ( PE ) DEFINITION – NICE New onset hypertension ( > 140/ 90 ) after 20 weeks of pregnancy AND

Co-existence of 1 or more of the following new-onset conditions

proteinuria ie

urine : creatinine ration of 30 mg /mmol or more OR

ACR of 8 mg /mmol or more

atleast 1 g / litre ( 2 + ) on dipstick testing OR

renal insufficiency ( creatinine > 90 micromol / L or more , 1.02 mg / 100 ml or more )

liver involvement ( elevated liver enzymes with or without RUQ or epigastric pain )

neurological complications as eclampsia ( lightening in Greek - a convulsive condition associated with eclampsia ) , altered mental state , blindness , stroke , clonus , severe headaches or persistent visual scotomata

haematological complications as thrombocytopenia ( < 150,000 /microlitre ) , disseminated intravascular coagulation or hemolysis

Uteroplacental dysfunction as fetal growth restriction , abnormal umbilical artery Doppler waveform analysis or still birth

Major cause worldwide of maternal deaths , severe maternal morbidity , intensive care admissions , C-section and prematurity

Incidence ranges from

3 % to 7 % for nulliparas

1 % to 3 % for multiparas

Worldwide pre-eclampsia affects...