gynecology and obstetrics
Preeclampsia and Eclampsia
Symptoms and Signs of Preeclampsia and Eclampsia
Preeclampsia may be asymptomatic or may cause edema or sudden excessive weight gain (> 5 lb/week). Nondependent edema, such as facial or hand swelling (the patient’s ring may no longer fit her finger), is more specific than dependent edema. Petechiae may develop, as may other signs of coagulopathy. Eclampsia manifests as generalized (tonic-clonic) seizures. If pregnant women have new or worsening hypertension, check for swelling in the hands (eg, a ring that no longer fits) or face, which may be among the more specific findings in preeclampsia. Preeclampsia with severe featuresmay cause organ damage; these features may include Severe headache Visual disturbances Confusion Hyperreflexia Epigastric or right upper quadrant abdominal pain (reflecting hepatic ischemia or capsular distention) Nausea and/or vomiting Dyspnea (reflecting pulmonary edema, acute respiratory distress syndrome [ARDS], or cardiac dysfunction secondary to increased afterload) Oliguria (reflecting decreased plasma volume or ischemic acute tubular necrosis) Stroke (rarely) 