Pathophysiology of Pre-eclampsia
The guidelines recommend management of common obstetric conditions at primary and referral level, based on local experience and evidence-based practice. They are not intended as strict protocols nor as standard operating procedures, but rather as a guide to safe effective management of common obstetric problems. The guidelines should be most useful to interns, medical officers and registrars.
Complications of pre-eclampsia
Pre-eclampsia is a multiorgan endothelial disease affecting predominantly the circulatory, renal, central nervous, coagulation, liver & uteroplacental systems.
A poorly understood placental defect causes an angiogenic factor imbalance, which affects the endothelium (lining) of maternal blood vessels, resulting in vascular spasm, platelet aggregation & leakage of plasma from capillaries.
Pre-eclampsia complicates 5-8% of pregnancies in South Africa. There is no effective method of prevention, & the only known cure is termination of pregnancy. Early detection, treatment & follow up may help in reducing death & morbidity from complications of pre-eclampsia.
COMPLICATIONS OF PRE-ECLAMPSIA
Maternal
- Cerebrovascular accident
- Eclampsia
- Pulmonary oedema
- Renal failure
- Liver failure or liver haemorrhage
- Disseminated intravascular coagulation
- Abruptio placentae
- HELLP syndrome (haemolysis, elevated liver enzymes, low platelets)
Fetal/neonatal
- Intrauterine death from placental insufficiency
- Intrauterine death from abruptio placentae
- Intrauterine growth restriction
- Prematurity