Immediate maternal and fetal complications of pre-eclampsia

THE CONTEXT

Complications are more likely when pre-eclampsia is untreated. Maternal complications vary across pregnancy, labor, and the puerperium.

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Eclampsia is reported in 2% and is more frequent in acute than subacute cases.

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Complications include placental abruption, oliguria or anuria, retinal detachment, dimness of vision or blindness, and preterm labor.

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Other complications include HELLP syndrome, cerebral hemorrhage, acute respiratory distress syndrome, and DIC.

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During labor, eclampsia and postpartum hemorrhage may occur; the hemorrhage may be related to coagulation failure.

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Puerperal eclampsia usually occurs within 48 hours. Renal failure is another puerperal complication.

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Puerperal vasomotor collapse is associated with reduced sodium and chloride concentrations due to a sudden fall in corticosteroid level.

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Sepsis is associated with increased induction, operative interference, and low vitality.

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Fetal risk depends on the severity of pre-eclampsia, duration of pregnancy, and severity of hypertension.

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Chronic placental insufficiency can cause intrauterine growth restriction.

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Prematurity may result from spontaneous preterm labor or indicated preterm delivery.

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Intrauterine death may result from hypoxia or placental abruption. Birth asphyxia and the need for neonatal intensive care admission are also listed.

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