Preeclampsia

1. Pre-eclampsia
Team Ramrod Rocks!

2. Meow Here’s The Problem
Ginger is a 17-year-old high school student
First pregnancy and with no prenatal care.
About 22 weeks pregnant
Recently began to gain about 2 lbs per week.
Hypertension (BP 140/90)
Has proteinuria and edema (which explains
the rapid weight gain)
Increased serum creatinine levels
Decreased Renin and Aldosterone levels.
The doctor admits Ginger to the hospital for
observation, and orders magnesium sulfate
injection to be ready in case of seizure

3. Pre-eclampsia
Also know as Toxemia
Cause is unknown, but occurs only in pregnant women
could be related to the placenta failing to implant properly in
the lining of the uterus; preventing arteries from dilating as
they should, restricting blood flow and leading to a host of
other problems
No known cure (other than having the baby)
High risk for first pregnancies, multiple gestations,
women under age 20, pre-existing hypertension, or
diabetes
Occurs after 20 weeks gestation
Usually detected early with adequate prenatal care

4. Signs & Symptoms
Principle Signs:
Proteinuria (protein in urine)
Hypertension due to vasoconstriction
Other signs & symptoms include:
edema
rapid weight gain
∆’s in vision
HELLP syndrome (20% of women with
severe pre-eclampsia)
Hemolysis (breakdown of RBC) Elevated
Liver enzymes, and Low Platelets
Rapid progression of Pre-eclampsia
may not show such symptoms.

5. Decrease in Renin and Aldosterone
due to high BP
Normal Blood Volume/ Normal BP
Na
+
, Water K
+
, Na
+
BP
KIDNEY KIDNEY
Aldosterone Renin
(plasma) (plasma)
ADRENAL CORTEX
(Zona Glomerulosa)
ACE
Angiotensin II Angiotensin I Angiotensinogen
(lungs)
Vasoconstriction ( BP, and venous return)
Stimulates ADH release
Thirst

6. Increased Levels of Creatinine
Creatinine is a non-protein
waste product of creatine
phosphate metabolism by
skeletal muscle tissue.
Vasoconstriction leads to a
decrease in blood flow to
organs, including the kidneys.
The result is decreased
filtration rates of this byproduct
and potential renal failure.

7. Magnesium Sulfate Injections
Pre-eclampsia can lead to eclampsia
(uncontrolled convulsions & dangerous
HTN).
The control of convulsions is the most
important aspect in the management of
eclampsia, and MgSO
4
is a very effective
anticonvulsant.
This drug works by inhibiting Ach release at
the neuromuscular junction, thereby
reducing striated muscular contraction.

8. Why do we care meow?
Leading global cause of maternal and
infant illness and death.
Conservative estimates of 76,000 deaths
per year
Pre-eclampsia occurs in approximately
5-8% of pregnancies

9. How does this affect mom and baby?
Can kill or harm the baby
because of the placenta
receiving too little blood flow
and oxygen.
Can cause low birth weight.
Ideally, you can induce labor if
late enough in the pregnancy.
Otherwise, bed rest and
constant observation.

10. “I Can’t Pull Over Any Farther”
Pre-eclampsia is like
physiology class
You get about halfway through
the class (pregnancy) when
you get your midterm grade
back (pre-eclampsia)
To save your G.P.A. (fetus)
you may drop the class
(induced labor) or study more
and finish the class (with bed
rest) or make some Sangria for
Janice (taking blood pressure
medication)

11. Questions?Questions?