Clinical signs and progression of pre-eclampsia

THE CONTEXT

Pre-eclampsia may manifest through rapid weight gain, hypertension, edema, and evidence of placental or systemic involvement.

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Weight gain exceeding 4 lb (1.8 kg) per week in the later months of pregnancy is significant.

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Blood pressure usually rises insidiously, although the rise may be abrupt.

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Diastolic pressure usually rises before systolic pressure.

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Visible ankle edema on rising from bed in the morning is pathological and may spread to other body parts in uncared cases.

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Sudden generalized edema may indicate imminent eclampsia.

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Pulmonary edema is attributed to leaky capillaries and low oncotic pressure.

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Abdominal examination may reveal chronic placental insufficiency, including scanty liquor or fetal growth restriction.

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Brisk patellar reflexes and clonus may occur. Laboratory abnormalities reflect hepatic, renal, and hematological involvement.

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The usual sequence of manifestations is rapid weight gain, visible edema, hypertension, and then proteinuria.

NEETx

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