Eclampsia and Preeclampsia: The Daily PANCE Blueprint

Eclampsia and Preeclampsia: The Daily PANCE Blueprint

What best describes the time that preeclampsia is commonly seen?

A. Before 18 weeks of pregnancy
B. After 18 weeks of pregnancy
C. After 16 weeks of pregnancy
D. After 20 weeks of pregnancy
E. Before 12 weeks of pregnancy

Answer and topic summary

The answer is D after 20 weeks of pregnancy

Preeclampsia is a systemic disease characterized by hypertension that is accompanied by proteinuria. Preeclampsia usually begins after the 20th week of gestation; however, it can appear at any time during pregnancy. It occurs most frequently in the final trimester.

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Pearls

  • Preeclampsia is a systemic disease characterized by hypertension that is accompanied by proteinuria after the 20th week of gestation.
  • If left untreated, preeclampsia can lead to serious and even fatal complications.
  • Risk factors include nulliparity, age younger than 19 or older than 35, obesity, multiple gestations, positive family history, pre-existing hypertension or renal disease, and diabetes mellitus.
  • Eclampsia is defined as the development of seizures in a woman with preeclampsia.

Diagnosis = Hypertension PLUS proteinuria

  • Mild Preeclampsia
    • BP 140/90 – 160/110
    • Proteinuria – > 300 mg/24 hours or > +1 on dipstick
  • Severe Preeclampsia
    • BP > 160/110
    • Proteinuria > 5 g in 24 hours or no urine or 3 +on dipstick
  • ***HELLP SYNDROME – Hemolysis, elevated liver enzymes, and low platelets
  • Eclampsia
    • The patient meets all criteria for preeclampsia + seizures or coma. This is life-threatening for the mother and fetus

Treatment

  • Delivery is the only cure for preeclampsia. The decision to induce depends on the stage of pregnancy and the severity of the disease
  • Patients with preeclampsia without severe symptoms are generally induced into labor after 37 weeks gestation. In severe preeclampsia, the delivery may be performed sooner.
  • If less than 34 weeks, antenatal steroids promote fetal lung development
  • Intravenous magnesium sulfate as seizure prophylaxis)

Smarty PANCE Content Blueprint Review:

Covered under ⇒ PANCE Blueprint Reproductive System (7%)Hypertension disorders in pregnancy