Essay On Preeclampsia

Preeclampsia

Tiffany McClure

Southern Utah University Disease Introduction

Preeclampsia and eclampsia are mysterious aliments affecting about 5-8% of all pregnant women (http://www.preeclampsia.org/health-information/about-preeclampsia). Symptoms of preeclampsia do not usually appear until 20 weeks gestation. Hypertension and proteinuria are the first two clinical signs confirming a diagnosis of preeclampsia. The disease is a multisystem, vasospastic disorder causing reduced organ perfusion with symptoms ranging from mild to severe. A systolic blood pressure reading of 140 and a diastolic of 90 accompanied by a presence of protein in the mother’s urine characterizes mild preeclampsia. Severe preeclampsia is characterized by a

Symptoms appearing during pregnancy and disappear soon after giving birth. It is known that preeclampsia is more common in primigravidas, younger and older mothers, family history, obesity, multiple gestations, and chronic medical disorders. A paternal factor has been identified as well (textbook). Scientific theories suggest preeclampsia could be derived from oxidative stress, immunologic intolerance between the placenta and mother, genetics, inflammatory factors, maternal vascular disease, superabundant trophoblast tissue, and angiogenic imbalances (Bell, 2010). It is known that preeclampsia can lead to low fetal birth weights resulting from decreased placental perfusion related to the mother’s increasing blood pressure and vasospasm. Poor placental perfusion then leads to early degenerative aging of the placenta increasing the risk for placental abruption (book).

Monitor, Monitor, Monitor

Women diagnosed with preeclampsia are closely monitored by their providers to assess the progression of the disease. Urine analysis is needed for every prenatal visit to measure the amount of protein present. Biophysical monitoring is needed when indicated to help determine any fetal distress. Assessment of uterine tone and monitoring for any bleeding is important as well since the chance for placental abruption is increased in preeclamptic women. Delivery of the fetus depends on how far gestation the mother

There is no known cure at this time for preeclampsia. The only “cure” known today is delivery of the fetus. Delivery is contingent upon a multitude of factors including maternal or fetal compromise, the severity of the symptoms, the disease progression, and the week’s gestation. Other risk factors for premature delivery include intrauterine growth restriction, thrombocytopenia, organ dysfunction, epigastric pain, neurologic disturbances, and fetal hemodynamic stability (McCoy, Baldwin, 2009). Providers may treat the increasingly high blood pressure with intravenous hydralazine, labetalol, intravenous nicardipine, sodium nitroprusside, beta-adrenergic blockers, and diuretics. Patients on diuretics should be monitored closely to prevent further blood volume deficiencies and are contraindicated in fetal distress. Magnesium sulfate is the most accepted evidence based drug of choice in the treatment of preeclamptic symptoms. Magnesium sulfate provides the mother and fetus with two benefits. The first is the prevention of seizures in a patient with severe preeclampsia progressing to eclampsia. Maternal mortality is also decreased among patients on magnesium sulfate during labor (McCoy, Baldwin, 2009). Nursing interventions for mothers on mag include monitoring the mother’s respiratory status, deep tendon reflexes, and therapeutic