PRE-ECLAMPSISA

Introduction 

Preeclampsia is a severe hypertensive disorder occuring during pregnancy usually it appears after 20th week of gestation. It is more common during third trimester. If left untreated for the pregnant women and her fetus. 

Definition 

Pre-Eclampsia is a disorder of unknown etiology characterized by development of hypertention to the extent of 140/90 mmHg during pregnancy. 

Or

It is an abnormal condition usually appears after 20th week of pregnancy and is characterized by hypertention, protein urea and edema in a all pregnancy. 

Incidence Rate 

• 5 to 10 % of all pregnancy

Causes 

• Exact causes is unknown but some risk factor are 
• Maternal age (above 35 year or below 18 year) 
• Primigravida
• Presence of hydatiform mole 
• Obesity
• Diabetic women
• Family history of hypertention, Pre-Eclampsia, 
• H/o Pre-eclampsia during previous pregnancy 
• H/o Renal disease

Clinical Manifestation

• Headache
• Nausea and vomiting
• Edema 
• Blurred vision
• Weight gain
• Continuous and severe pain in epigastric region
•  Decrease urine output
• Dizziness Disturbed sleep pattern

Diagnostic Evaluation 

• History Collection 
• Physical Examination 
• CBC
• HB level 
• TLC and DLC 
• Platelets Count
• RFT
• LFT such as SGOT or SGPT 
• Urine examination 
• Opthalmic Examination 
• FHSM 

Management 

# Medical Management 

• Antihypertensive drug :- These drugs are given for maintaining and controlling blood pressure in normal range. 
• Following drugs are used:- 
• Beta adrenargic Blockers :- Propranolol, Lebetalol 
• Vasodilator drug :- Sodium niteopruside, Hydralazine,
• Centrally acting sympatholytics :- Methyldopa 
• Peripheral acting alpha adrenargic blocker :- Dexozosin, Prazosin 
• Calcium channel blockers :- Nicardipine , Nefedipine. 
• Diuretic Drug :- These are used for increasing urine output and reducing edema. EX :- Frusemide (Lasix) 
• Sadative Drug :- These drugs are given to promote sleep pattern and controle emotional factor these are responsible for hypertensive. Eg :- Phenobarbitone.
• Mild laxative :- If the patient suffering from constipation. 
• Prophyletic Anticonvulsive agent :- In case of severe pre-eclampsia seizures may appear so the patient should be given prophyletic anticonvulsive drug (Magnisium sulphate )

NURSING MANAGEMENT 

The patient should be admitted to the hospital wheres facility for obstetrician and pediatrician is available .

Well occupied labour room, OT, and NICU.

Imediate after admition of the patient following should is done 

1. Assessement of vital sign specially focus on B.P. 

2. Assessement of vision

3. Assessement of weight 

5. Assessement of nutritional and hydration level 

6. Assessement of fetal well being 

7. Provide comfortable position and complete bed rest because bed rest reduces the severity of pre-eclamtic features. 

COMPLICATION 

• Maternal 
• Eclampsia 
• Abritio placenta 
• Oliuria 
• Vision problem
• HELLP Syndrome
•        Hemolysis
•        Elevated liver enzymes 
•        Low pletelet count
• Sudden Hemorrahge 
• Preterm Labor
• PPH
• Puperal sepsis
• Pre-eclampsia in next pregnancy increase risk for organ damage, liver, kidney, heart etc.