Pre-eclampsia is a complex clinical syndrome characterised by hypertension (>140/90mmHg measured 2 times) and proteinuria (>300mg/24hr) that appears after 20 weeks of gestation in previously normotensive women. Edema and fluid retention often occur as well.The intense prolonged vasospastic process observed in pre-eclampsia causes endothelial injury that leads to platelet adherence and fibrin deposition that can potentially affect any organ. Chronically hypertensive women are at increased risk mainly for superimposed pre-eclampsia and abruptio placentae, both of which increase neonatal morbidity and mortality.
Pre-eclampsia, especially in its severe form, can lead to maternal convulsions, central nervous system haemorrhage, pulmonary edema, liver function abnormalities, renal failure, and also thrombocytopenia in case of the HELLP-syndrome. In eclampsia, severe convulsions of 1-2 minutes can occur followed by coma.
The chief requirements for successful management of pre-eclampsia are early diagnosis, close follow up, and timely delivery. Because severe pre-eclampsia might result in rapid deterioration of both mother and fetus, prompt delivery is indicated in cases of imminent eclampsia, multiorgan dysfunction, and fetal distress.