Laboratory evaluation, fetal monitoring and progression of pre-eclampsia
THE CONTEXT
Assessment of pre-eclampsia includes maternal blood investigations and fetal wellbeing surveillance because widespread organ dysfunction may progress to end organ damage.
Maternal blood investigations
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The listed investigations include AST, ALT and LDH concentrations, platelet count, serum creatinine, serum uric acid and coagulation profile.
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Thrombocytopenia is defined as a platelet count below 100,000/µL.
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Doubling of serum creatinine concentration is a listed renal abnormality.
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A coagulation profile is unnecessary when the platelet count and liver enzymes are normal.
Antenatal fetal wellbeing assessment
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Assessment includes clinical examination and daily fetal kick counts.
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Ultrasonography assesses fetal growth and liquor pockets.
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Additional methods include cardiotocography, umbilical artery flow velocimetry and the biophysical profile.
Disease progression
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An imbalance of angiogenic and antiangiogenic factors leads to widespread organ dysfunction and ultimately end organ damage.
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Clinical manifestations include hypertension and signs of renal, hepatic, pulmonary and cerebral dysfunction.