Page 15 - OB Risks - Delivering the Goods (Part Two)
P. 15

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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