Pathophysiology
1) symptoms complex occurring in second or third trimester of pregnancy, with hypertension, proteinemia, edema, and convulsions 2) exact pathogenesis remains elusive
Signs and Symptoms
1) hypertension (diastolic > 85 mmHg and systolic > 140 mmHg in third trimester 2) hyperreflexia (preeclampsia) 3) convulsions (eclampsia) 4) edema secondary to sodium retention 5) positive “rollover” test (diastolic pressure increases at least 20 mmHg when changing from lateral recumbent to supine position) 6) oliguria
Characteristic Test Findings
Laboratory – 1) proteinuria 2) coagulopathy
Histology/Gross Pathology
1) fibrin thrombi in liver, glomeruli, and brain 2) placental infarcts 3) atherosis of placental vessels
Biochemistry
1) dysregulation of vascular cell adhesion molecule 1 (VCAM-1) 2) increased sensitivity to angiotensin 2
Treatment
1) bedrest 2) removal of undue stress and stimulation 3) magnesium sulfate to control neurologic manifestations 4) hydralazine and methyldopa for blood pressure control 5) “best treatment is delivery of fetus
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