Pre-Eclampsia, Tekanan Darah Tinggi ketika Hamil

Question: Are There Different Kinds of Preeclampsia?
Answer: Yes. A medical distinction is made between mild forms of preeclampsia and severe forms of preeclampsia.

Mild preeclampsia is diagnosed when:
*Pregnancy is greater than 20 weeks
*Blood pressure is greater than 140 systolic or 90 diastolic
  0.3g of protein is collected in a 24-hour urine sample, or persistent 1+ protein measurement on urine dipstick
*There are no other signs of problems with the mother or the baby


Severe preeclampsia is a more serious problem. Diagnosis of severe preeclampsia requires the basic features of mild preeclampsia as well as some indication of additional problems with either the mother or the baby. Thus, one of the following findings is also necessary for a diagnosis of severe preeclampsia:
1. Signs of central nervous system problems (severe headache, blurry vision, altered mental status)
2. Signs of liver problems (nausea and/or vomiting with abdominal pain)
3. At least twice the normal measurements of certain liver enzymes on blood test
4. Very high blood pressure ( greater than 160 systolic or 110 diastolic)
5. Thrombocytopenia (low platelet count)
6. Greater than 5g of protein in a 24-hour sample
7. Very low urine output (less than 500mL in 24 hours)
8. Signs of respiratory problems (pulmonary edema, bluish tint to the skin)
9.Severe fetal growth restriction
10. Stroke

Preeclampsia and Eclampsia
What Is Preeclampsia?

Also referred to as toxemia, preeclampsia is a condition that pregnant women can get. It is marked by high blood pressure accompanied with a high level of protein in the urine. Women with preeclampsia will often also have swelling in the feet, legs, and hands. Preeclampsia, when present, usually appears during the second half of pregnancy, generally in the latter part of the second or in the third trimesters, although it can occur earlier.

What Is Eclampsia?

Eclampsia is the final and most severe phase of preeclampsia and occurs when preeclampsia is left untreated. In addition to the previously mentioned signs of preeclampsia, women with eclampsia often have seizures. Eclampsia can cause coma and even death of the mother and baby and can occur before, during, or after childbirth.

What Causes Preeclampsia and Eclampsia?

The exact causes of preeclampsia and eclampsia are not known, although some researchers suspect poor nutrition, high body fat, or insufficient blood flow to the uterus as possible causes.

Who Is at Risk for Preeclampsia?Preeclampsia is most often seen in first-time pregnancies and in pregnant teens and women over 40. Other risk factors include:
1.A history of high blood pressure prior to pregnancy.
2.Previous history of preeclampsia.
3.A history of preeclampsia in mother or sisters.
4.Obesity prior to pregnancy.
5.Carrying more than one baby.
6.History of diabetes, kidney disease, lupus, or rheumatoid arthritis.


What are the Signs of Preeclampsia?

In addition to swelling, protein in the urine, and high blood pressure, symptoms of preeclampsia can include:
Rapid weight gain caused by a significant increase in bodily fluid
1.Abdominal pain
2.Severe headaches
3.A change in reflexes
4.Reduced output of urine or no urine
5.Dizziness
6.Excessive vomiting and nausea

Does Swelling Mean I Have Preeclampsia During Pregnancy?Some swelling is normal during pregnancy. However, if the swelling doesn't go away with rest and is accompanied by some of the above symptoms, be sure to see your doctor right away.

How Can Preeclampsia Affect My Baby?Preeclampsia can prevent the placenta from receiving enough blood, which can cause your baby to be born very small. It is also one of the leading causes of premature births and the difficulties that can accompany them, including learning disabilities, epilepsy, cerebral palsy, and hearing and vision problems.

What Is the Treatment for Preeclampsia and Eclampsia?

The only real cure for preeclampsia and eclampsia is the birth of the baby.

Mild preeclampsia (blood pressure greater than 140/90 that occurs after 20 weeks of gestation in a woman who did not have hypertension before; and/or having a small amount of protein in the urine can be managed with careful hospital or in-home observation along with activity restriction.

If the baby is pre-term, the condition can be managed until your baby can be safely delivered. Your health care provider may prescribe bed rest, hospitalization, or medication to prolong the pregnancy and increase your unborn baby's chances of survival. If your baby is close to term, labor may be induced.

The treatment for more severe preeclampsia (having vision problems, lung problems, abdominal pain, fetal distress, or other signs and symptoms) may require more emergent treatment -- delivery of the baby -- irrespective of the baby's age.

Other treatments include:
Magnesium can be injected into the veins to prevent eclampsia-related seizures.
Hydralazine or another antihypertensive drug to manage severe elevations of blood pressure.
Monitoring fluid intake.