Page 15 - OB Risks - Delivering the Goods (Part Two)
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SVMIC Obstetrics Risks: Delivering the Goods
features. The management of gestational hypertension and
22
that of preeclampsia without severe features is similar in many
aspects, and both require enhanced surveillance.
Preeclampsia is a disorder of pregnancy associated with
new-onset hypertension, which occurs most often after 20
weeks of gestation and frequently near term. Although often
accompanied by new-onset proteinuria, hypertension and
other signs or symptoms of preeclampsia may present in
some women in the absence of proteinuria. It is important to
remember that most cases of preeclampsia occur in healthy
nulliparous women with no obvious risk factors. Studies
have found that using headache as a diagnostic criterion for
preeclampsia with severe features is unreliable and nonspecific.
Thus, an astute and circumspect diagnostic approach is
required when other corroborating signs and symptoms
indicative of severe preeclampsia are missing. Of note, in the
setting of a clinical presentation similar to preeclampsia, but at
gestational ages earlier than 20 weeks, alternative diagnoses
should to be considered, including but not limited to thrombotic
thrombocytopenic purpura, hemolytic–uremic syndrome, molar
pregnancy, renal disease, or autoimmune disease. Preeclampsia,
also known as toxemia, can cause serious problems for both the
mother and the baby if left untreated.
23
Hypertension-related disorders account for approximately 7.4
percent of the almost 800 pregnancy-related deaths that occur
each year In the United States.
24
22 Id.
23 Id.
24 https://pubmed.ncbi.nlm.nih.gov/26158653/
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