Preeclampsia

Definition

Synonym: late stasis, pregnancy poisoning; Preeclampsia is a form of high blood pressure (hypertension) caused by pregnancy. By definition, high blood pressure must not have existed before the 20th week of pregnancy. In addition to high blood pressure, which can exceed 140/90 mmHg, there is also proteinuria.

This means that there is a loss of proteins with the urine via the kidneys. If kidney function were intact, these proteins would be filtered out of the urine and remain in the body. By definition, in pre-eclampsia more than 300 mg of protein is lost via the urine every 24 hours.

In the absence of proteinuria, pre-eclampsia can occur if the kidney or liver is affected, if there is abnormal blood count or neurological abnormalities. Furthermore, retarded fetal growth in the presence of existing gestational hypertension is also considered pre-eclampsia. The old term “EPH gestosis” is no longer used for pre-eclampsia.

Causes for the occurrence of pre-eclampsia

The causes for the occurrence of pre-eclampsia are still the subject of research. Although there are known risk factors, the exact mechanism of the disease is not yet fully understood. Various disorders of the prostaglandin metabolism as well as a disturbed adaptation of important vessels of the placenta are discussed.

According to one study, a vitamin D deficiency in early pregnancy is also believed to increase the risk of pre-eclampsia. Furthermore, blood pressure-regulating substances, known as endothelial factors, play a central role in the development of pre-eclampsia. The higher the sFlt-1/PIGF-quotient, the higher the probability of developing pre-eclampsia.

This quotient measures important factors in the blood supply of the child and the placenta. It increases if the placenta is undersupplied. A certain genetic risk cannot be dismissed either.

Immunological and hormonal factors are also suspected. However, many women ask themselves whether there are concrete risk factors for the occurrence of pre-eclampsia. There are indeed general and pregnancy-related risk factors.

The following overview summarizes the risk factors for pre-eclampsia. The more risk factors that apply to a person, the higher the risk of pre-eclampsia. 1. pregnancy-related risk factors: 2. general risk factors

  • 1.

    1. pre-eclampsia in a past pregnancy or any other pregnancy-related disease associated with high blood pressure

  • 1. 2. primipara (60-70% of all pre-eclampsia are detected in primipara)
  • 1. 3. multiple pregnancies
  • 1.

    4. gestational diabetes

  • 1. 5. fetal chromosome aberrations
  • 2. 1. thrombophilia: antiphospholipid syndrome
  • 2.

    2. overweight: BMI>35

  • 2. 3. diabetes mellitus
  • 2. 4. autoimmune diseases
  • 2.

    5. family burden

  • 2. 6. existing kidney disease
  • 2. 7. age>40 years