Preeklampsiat

Preeklampsiat are pregnancy-related hypertensive disorders that typically develop after 20 weeks of gestation. They are defined by new-onset hypertension combined with proteinuria or with signs of end-organ dysfunction. When seizures occur, the condition progresses to eclampsia.

The exact cause is not fully understood, but abnormal placentation leading to systemic endothelial dysfunction and vasoconstriction is thought to play a central role. The condition can affect multiple organs, including the kidneys, liver, brain, and placenta, and it can contribute to fetal growth restriction and placental abruption.

Risk factors include a first pregnancy, multiple gestations, chronic hypertension, kidney disease, diabetes, obesity, autoimmune disorders, and a history of preeklampsiat. Advanced maternal age and certain ethnic backgrounds are also linked to higher risk. Lack of access to quality antenatal care can worsen outcomes.

Diagnosis relies on persistent hypertension (systolic ≥140 mmHg or diastolic ≥90 mmHg on two occasions) after 20 weeks, plus proteinuria (≥300 mg/24 h) or signs of organ dysfunction. In the absence of proteinuria, diagnosis can be made with severe features such as low platelets, high liver enzymes, kidney injury, pulmonary edema, or neurological symptoms.

Management aims to protect the mother and fetus and depends on gestational age and severity. Blood pressure control with medications such as labetalol or nifedipine, and magnesium sulfate for seizure prophylaxis in severe cases, are common. Delivery remains the definitive treatment when maternal or fetal status warrants it, with timing tailored to risk and viability.

Prognosis improves with timely detection and management, though complications can include placental abruption, fetal growth restriction, stroke, or organ failure. Recurrence risk is higher in future pregnancies. Prevention strategies for high-risk individuals may include risk assessment and, when appropriate, low-dose aspirin started early in pregnancy.