[Maternal] Preeclampsia 자간전증

Pathophysiology

-Systemic vasospasm

-Onset > 20 weeks gestation

-Risk factors: 

• Chronic hypertension
• Prior history of preeclampsia
• Diabetes mellitus
• Multiple gestation (eg. twins)

Clinical features & diagnostic criteria

Preeclampsia without Severe Features

• systolic BP >140 or diastolic BP > 90mmHg
• Proteinuria

Preeclampsia with Severe features

• >160 or 110 mmHg
• Thrombocytopenia
• Increased Creatinine
• Increased LFTs
• -> moms have risk of stroke. 

HELLP!!!!! (Hemolysis, Elevated Liver enzymes, Low Platelets) syndrome

 

Complications

Maternal

1. Acute kindney injury

2. Pulmonary edema

3. Ischemic stroke

4. Hepatic failure or rupture

5. Disseminated intravascular coagulation (DIC)

6. Progression to eclampsia

 

Fetal

1. Placental abruption

2. Restricted growth

3. Preterm birth

4. Fetal demise

 

only treatment: delivery

 

Nursing Interventions

*Facilitate and prepare for birth -> only definitive treatment

*Hourly intake and output

*Assess deep tendon reflexes for hyperreflexia and clonus, which may indicate increased CNS irritability and precede eclmpsia; hyporeflexia may indicate magnesium toxicity

*Antihypertensives (Stroke prophylaxis)

*Seizure prophylaxis (Seizure precaution, Magnesium sulfate ->Monitor mom for signs of magnesium toxicity)