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2-8. Preeclampsia

Preeclampsia is the first stage of a pregnancy condition commonly called toxemia. The earliest signs of toxemia (preeclampsia) must be detected to prevent the condition from progressing to full eclampsia which involves convulsions and coma and can result in death.

Signs and Symptoms. Problems indicating preeclampsia may develop over the period of a few days or appear suddenly in a 24-hour period. Included are the following:

  • High blood pressure. The patient's circulation changes, affecting the blood flow to the kidneys. The kidneys start losing track of how much sodium they are supposed to excrete to maintain the body's salt balance. At this time, the kidneys begin to control the patient's blood pressure, causing the blood pressure to rise.
  • Edema, usually of the face, hands, and/or feet.
  • Headaches.
  • Blurred vision.
  • Abdominal pain.

Treatment. If treated early, it is possible to prevent preeclampsia from progressing rapidly to full-blown eclampsia and intractable seizures before, during, and after delivery.

  • Record a blood pressure and the presence or absence of edema in every pregnant woman you examine. Do this regardless of what the patient's chief complaint is.
  • Be suspicious of any blood pressure above 130/80.
  • Give supportive care and direct the patient to an obstetrician.

David L. Heiserman, Editor

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Revised: June 06, 2015