pre-eclapsiai a nutshell

1. Pre-eclampsia

2. Pre-eclampsia
Pre-eclampsia is a disorder that can occur after
the twentieth week (20th ) of pregnancy, during
childbirth and up to 48 hours postpartum.
Pre-eclampsia is characterized by increase
BP(hypertension) presence of albumin and
globulin (proteinuria) and edema.

3. Pre-eclampsia
Signs:
Edema:
Occult edema recognized by rapid weight gain( total
weight gain in pregnancy does not exceed 20 ponds
and not more 1 pond/week).
Clinical edema appears in ankles spread over tibia
and severe cases fingers, face become puffy and
generalize edema of whole body.
If BP is 160/ 100 mmhg fetus is in danger and
mother may go to Eclampsia.

4. Pre-eclampsia
Hypertension:
PB equal to or higher than 140/90 mmHg
If BP is 160/ 100 mmhg fetus is in danger and
mother may go eclampsia.
Proteinuria:
Proteinuria is characterized by the loss of protein in
the urine. Pre-eclampsia is diagnosed when 2+/ value
≥ 0.3g or more protein in the 24-hour urine
associated with increased blood pressure.

5. Pre-eclampsia

6. Pre-eclampsia
Types of Pre-eclampsia:
Mild Pre-eclampsia:
Ankle edema BP ranging from 120/80 mmhg
to 140/90 mmhg and trace of protein in the
urine. (preferable to arrange hospital admission
or examination twice a week)

7. Pre-eclampsia
Severe Pre-eclampsia:
Edema in ankle, tibia and may be generalized,
BP is over 160/100 mmhg and increase in
proteinuria. Also severe headache, visual
disturbance nausea vomiting and epigastric
pain.
(with these signs if patient remain untreated
eclampsia will occur).

8. Pre-eclampsia
Diagnosis:
Antenatal care
 Every 3 weeks until 28 weeks.
 Every 2 weeks until 32 weeks.
 Every week until delivered.
Assessment for weight gain, ankle swelling, increase BP
and proteinuria are recorded and these signs present
patient is referred to a doctor.
Urine Analysis (urine dipstick, 24 hour urine collection)

9. Pre-eclampsia
Management:
Rest in bed (removes edema, decrease BP and
improves circulation)
Diet (recommend high protein diet milk, fish, meat,
fruit and vegetables)
Salt Restriction (less salt intake for mild cases and
no salt for severe cases)
Diuretics (to decrease edema by increasing urine
output)
Antihypertensive Drugs (to decrease BP)

10. Pre-eclampsia
Nursing Management:
Record BP (daily for mild cases and 4 hourly for
severe cases)
Test urine daily for presence of protein.
Record fluid intake out put.
Assess edema daily.
Weigh patient twice a week.
Complete bed rest for severe cases (mild case patient
is allowed to go to toilet)
Provide high protein and low salt diet
Diuretic and antihypertensive medication as per order

11. Pre-eclampsia
Obstetric Management:
To avoid intrauterine death and eclampsia, termination of
pregnancy is done by induction of labor.
Mild cases:
Surgical induction by rupture of membrane or by oxytocic
drip.
C-section for cephalo pelvic disproportion, precious baby,
failure of surgical induction.
Severe Case:
If labor is delayed even after surgical induction or oxytocic
drip c- section is performed.

12. Pre-eclampsia
Complications:
Eclampsia
Accidental Hemorrhage
Intrauterine death

13. Summary