Complications of Preeclampsia


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About complications: Complications of Preeclampsia are secondary conditions, symptoms, or other disorders that are caused by Preeclampsia. In many cases the distinction between symptoms of Preeclampsia and complications of Preeclampsia is unclear or arbitrary.

Complications list for Preeclampsia: The list of complications that have been mentioned in various sources for Preeclampsia includes:

Complications of Preeclampsia: The effects of high blood pressure during pregnancy vary depending on the disorder and other factors. According to the National High Blood Pressure Education Program (NHBPEP), preeclampsia does not in general increase a woman's risk for developing chronic hypertension or other heart-related problems. The NHBPEP also reports that in women with normal blood pressure who develop preeclampsia after the 20th week of their first pregnancy, short-term complications--including increased blood pressure--usually go away within about 6 weeks after delivery.1

Maternal complications acutely can include pulmonary edema, thrombotic complications, renal failure, and death. Preeclampsia can evolve into eclampsia, leading to maternal seizures. One specific subset of signs and symptoms known as the HELLP Syndrome (Hemolysis, Elevated Liver Enzymes, and Low Platelets) is a cause of extensive morbidity. In the United States, hypertensive disorders of pregnancy account for nearly 15 percent of maternal mortality; throughout the world these conditions are responsible for more than a third of maternal deaths. The vast majority of these deaths and most infant deaths are due to preeclampsia and eclampsia, arising either de novo or superimposed on chronic hypertension. Long-term sequelae may also result. Women with chronic hypertension have an obvious long-term risk from the persistent hypertension. However, women with preeclampsia, despite the resolution of the disorder postpartum, are also at increased risk of cardiovascular disease in later life compared to women with pregnancies without preeclampsia. 2

Fetal complications of hypertensive disorders of pregnancy include growth restriction, prematurity, and stillbirth. In addition, there is evidence that the intrauterine milieu in a hypertensive pregnancy may, by mechanisms related to the failure of the fetus to exercise full growth potential, confer increased risk of cardiovascular events in adult life. 2

Women with preeclampsia are at increased risk of cardiovascular disease compared to women who have pregnancies without preeclampsia. Epidemiological studies indicate that this likely is the result of common risk factors for preeclampsia and cardiovascular disease rather than preeclampsia causing cardiovascular disease. Most of the risk factors for preeclampsia (e.g., race, dyslipidemia, obesity, diabetes, hypertension, and elevated homocysteine) are also risk factors for cardiovascular disease. Likewise, many of the pathophysiological features of preeclampsia (e.g., dyslipidemia, inflammatory and endothelial activation, insulin resistance) are features of cardiovascular disease. There is increasing evidence that women who have recovered from preeclamptic pregnancies manifest cardiovascular and metabolic differences compared to women who have had normal pregnancies. It is possible that the normal changes of pregnancy sensitize certain women to insults that would require years to manifest effects in the absence of pregnancy.

The long-term implications of preeclampsia for the offspring is another area about which little is known. Preeclampsia is associated with an increased risk of fetal growth retardation, but many children born to women with preeclampsia are appropriate for gestational age, and still others are large for gestational age. It is possible that the long-range outcome of even the growth restricted infants of preeclamptic infants is not the same as that of the usual growth-restricted infant. 2

Footnotes:
1. excerpt from High Blood Pressure in Pregnancy: NHLBI
2. excerpt from REPORT of the WORKING GROUP on RESEARCH on HYPERTENSION DURING PREGNANCY: NHLBI

Last revision: June 12, 2003

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