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3.9.2 - Pre-eclampsia and Eclampsia

from Section 3.9 - Obstetrics and Maternal Peripartum Complications

Published online by Cambridge University Press:  27 July 2023

Ned Gilbert-Kawai
Affiliation:
The Royal Liverpool Hospital
Debashish Dutta
Affiliation:
Princess Alexandra Hospital NHS Trust, Harlow
Carl Waldmann
Affiliation:
Royal Berkshire Hospital, Reading
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Summary

Key Learning Points

  1. 1. Pre-eclampsia is a major cause of mortality in developing countries. It remains a cause of significant morbidity and is a common reason for critical care admissions in the obstetric population in the UK.

  2. 2. Careful adherence to national guidelines on the treatment and prevention of pre-eclampsia should be followed when a patient is admitted to critical care and this requires a multidisciplinary approach.

  3. 3. Acute pulmonary oedema occurs in 3 per cent of patients with severe pre-eclampsia, and early diagnosis is essential to differentiate between hypertensive disease of pregnancy and other causes.

  4. 4. Haemolysis, elevated liver enzymes and low platelets (HELLP) is associated with pre-eclampsia and carries high maternal and neonatal morbidity.

  5. 5. Eclampsia can complicate severe pre-eclampsia or occur in stable or undiagnosed pre-eclampsia. Prompt delivery of the fetus should occur as soon as the mother has been stabilised.

Type
Chapter
Information
Intensive Care Medicine
The Essential Guide
, pp. 316 - 319
Publisher: Cambridge University Press
Print publication year: 2021

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References

References and Further Reading

Dennis, AT, Solnordal, CB. Acute pulmonary oedema in pregnant women. Anaesthesia 2012;67:646–59.CrossRefGoogle ScholarPubMed
Knight, M, Bunch, K, Tuffnell, D, et al.; MBRRACE-UK (eds). Saving lives, improving mothers’ care. Lessons learned to inform maternity care from the UK and Ireland Confidential Enquiries into Maternal Deaths and Morbidity 2017–19. Oxford: National Perinatal Epidemiology Unit, University of Oxford; 2021. www.npeu.ox.ac.uk/assets/downloads/mbrrace-uk/reports/maternal-report-2021/MBRRACE-UK_Maternal_Report_2021_-_FINAL_-_WEB_VERSION.pdfGoogle Scholar
National Institute for Health and Care Excellence. 2019. Hypertension in pregnancy: diagnosis and management. NICE guideline [NG133]. www.nice.org.uk/guidance/ng133/chapter/RecommendationsGoogle Scholar
Spasovski, G, Vanholder, R, Allolio, B, et al.; Hyponatraemia Guideline Development Group. Clinical practice guideline on diagnosis and treatment of hyponatraemia. Eur J Endocrinol 2014;170:G147. Erratum in: Eur J Endocrinol 2014;171:X1.CrossRefGoogle ScholarPubMed
The Regulation and Quality Improvement Authority. 2017. Guideline for the prevention, diagnosis and management of hyponatraemia in labour and the immediate postpartum period. www.rqia.org.uk/RQIA/files/df/dfd57ddd-ceb3-4c0d-9719-8e33e179d0ff.pdfGoogle Scholar

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