Answer: Fetal risks include: Growth restriction Oligohydramnios Placental infarction Placental abruption Consequences of prematurity (when maternal disease necessitates delivery remote from term) Uteroplacental insufficiency Perinatal death Maternal risks include: Central nervous system manifestations, including seizures and stroke Disseminated intravascular coagulation (DIC) and its complications Increased likelihood of cesarean delivery Renal failure Hepatic failure or rupture [...]

Answer: Immunologic response. Inadequate maternal antibody response to the fetal allograft results in vascular damage from the circulating immune complexes. This theory is supported by an increased prevalence of the disease in pregnancies with limited prior antigen exposure (young nulliparas) and in situations with increased fetal antigen (twins, molar pregnancy, hydropic pregnancies, and diabetics with [...]

Answer: No. Preeclampsia has been described since the time of the ancient Greeks. However, the cause remains unknown. We know that hypertension, proteinuria, and the other signs and symptoms of the illness are merely the outward manifestations of a systemic illness characterized by vasoconstriction and hypovolemia. All organs, including the fetoplacental unit, show evidence of [...]

Answer: Preeclampsia occurs in 6-8% of all live births. Risk factors include nulliparity, extremes of reproductive age (< 15 and > 35 years of age), African-American race, history of preeclampsia in a first-degree female relative, history of preeclampsia in a prior pregnancy, diabetes, chronic vascular or renal disease, chronic hypertension, and multiple gestations. Reference: American [...]

Answer: There is no apparent benefit to treatment of mild chronic hypertension (systolic blood pressure 140-179 mmHg, diastolic blood pressure 90-109 mmHg) in pregnancy. Patients who are newly diagnosed with mild disease during pregnancy can be monitored off medication for signs of worsening hypertension or superimposed preeclampsia. Patients with chronic hypertension should ideally have their [...]

Answer: Yes. Because of poor placental vascular development and ongoing elevations of blood pressure, the pregnancy is at risk for intrauterine growth restriction, abruption, and stillbirth. From a maternal perspective, the patient may develop superimposed preeclampsia and all of the associated consequences. Reference: American College of Obstetricians and Gynecologists: Chronic Hypertension in Pregnancy. ACOG Practice [...]

Answer: If a woman with known chronic hypertension develops increased blood pressures along with proteinuria, this is defined as surperimposed preeclampsia. It can be difficult to distinguish clinically between worsening of chronic hypertension and the development of superimposed preeclampsia. The development of proteinuria and the presence of other abnormalities associated with preeclampsia (e.g., headache, visual [...]