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Handbook of Clinical Laboratory Testing During Pregnancy pp 391–400Cite as

Preeclampsia, Eclampsia, and Hypertension

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Part of the book series: Current Clinical Pathology ((CCPATH))

Abstract

Hypertensive disorders of pregnancy complicate approx 10% of pregnancies and are leading causes of maternal mortality (1–3). Although preeclampsia occurs in 5 to 8% of pregnancies, it is a major contributor of premature deliveries and neonatal morbidity in the United States (4). Despite the recognition of eclampsia since ancient times, it was not until the late 1800s when an association between hypertension, edema, proteinuria, and eclampsia was suggested (5). The differentiation of preeclampsia-eclampsia from epilepsy, primary renal disease, and essential hypertension gained widespread acceptance only in the 1950s. Even today, distinguishing these clinical entities from preeclampsia can be difficult. More important, definition and classification of hypertensive diseases of pregnancy remain controversial.

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References

  1. Diagnosis and management of preeclampsia and eclampsia. ACOG Practice Bulletin No. 33. Washington, DC: American College of Obstetricians and Gynecologists, 2000, pp. 1–2.

    Google Scholar 

  2. Walker JJ. Pre-eclampsia. Lancet 2000; 356: 1260–1265.

    Article  PubMed  CAS  Google Scholar 

  3. Koonin LM, MacKay AP, Berg CJ, Atrash HK, Smith JC. Pregnancy-related mortality surveillance: United States, 1987–1990. Morb Mort Wkly Rep CDC Surveill Summ 1997; 46 (4): 17–36.

    CAS  Google Scholar 

  4. Report of the National High Blood Pressure Education Program Working Group on high blood pressure in pregnancy. Am J Obstet Gynecol 2000; 183: S1 - S22.

    Google Scholar 

  5. Lindheimer MD, Roberts JM, Cunningham FG, Chesley L. Introduction, history, controversies, and definitions. In: Lindheimer M, Cunningham FG, Roberts JM, ed. Chesley’ s Hypertensive Disorders in Pregnancy, 2nd ed. Stamford, CT: Appleton & Lange 1999, pp. 3–41.

    Google Scholar 

  6. Sibai BM. Treatment of hypertension in pregnant women. N Engl J Med 1996; 335: 257–265.

    Article  PubMed  CAS  Google Scholar 

  7. Lain KY, Roberts JM. Contemporary concepts of the pathogenesis and management of preeclampsia. JAMA 2002; 287: 3183.

    Article  PubMed  Google Scholar 

  8. Saudan P, Brown MA, Buddle ML, Jones M. Does gestational hypertension become preeclampsia? Br J Obstet Gynaecol 1996; 105: 1177–1184.

    Google Scholar 

  9. Saftlas AF, Olson DR, Franks AL, et al. Epidemiology of preeclampsia and eclampsia in the United States, 1979–1986. Am J Obstet Gynecol 1990; 163: 460.

    PubMed  CAS  Google Scholar 

  10. Witlin A, Sibai BM. Epidemiology and classification of hypertension in women. In: Sibai BM, ed. Hypertensive Disorders in Women. Philadelphia: W.B. Saunders, 2001;pp. 1–8.

    Google Scholar 

  11. Venuto RC, Lindheimer MD. Animal models. In: Lindheimer M, Cunningham FG, Roberts JM, ed. Chesley’s Hypertensive Disorders in Pregnancy, 2nd ed, Stamford, CT: Appleton & Lange, 1999, pp. 487–515.

    Google Scholar 

  12. Robertson WB, Bronsens I, Dixon HG. The pathological response of the vessels of the placental bed to hypertensive pregnancy. J Pathol Bacteriol 1967; 93: 581–592.

    Article  PubMed  CAS  Google Scholar 

  13. Brosens IA, Robertson WB, Dixon HG. The role of the spiral arteries in the pathogenesis of preeclampsia. Obstet Gynecol Ann 1972; 1: 177–191.

    CAS  Google Scholar 

  14. Khong TY, De Wolf F, Robertson WB, Brosens I. Inadequate maternal vascular response to placentation in pregnancies complicated by pre-eclampsia and by small-for-gestational age infants. Br J Obstet Gynaecol 1986; 93: 1049–1059.

    Article  PubMed  CAS  Google Scholar 

  15. De Wolf F, Robertson WB, Brosens I. The ultrastructure of acute arthrosis in hypertensive pregnancy. Am J Obstet Gynecol 1975; 123: 164–174.

    PubMed  Google Scholar 

  16. Benyo DF, Smarason A, Redman CW, Sims C, Conrad KP. Expression of inflammatory cytokines in placentas from women with preeclampsia. J Clin Endocrinol Metab 2001; 86 (6): 2505–2512.

    Article  PubMed  CAS  Google Scholar 

  17. Conrad KP, Miles TM, Benyo DF. Circulating levels of immunoreactive cytokines in women with preeclampsia. Am J Reprod Immunol 1998; 40 (2): 102–111.

    Article  PubMed  CAS  Google Scholar 

  18. Page NM, Woods RJ, Gardiner SM, et al. Excessive placental secretion of neurokinin B during the third trimester causes pre-eclampsia. Nature 2000; 405 (6788): 797–800.

    Article  PubMed  CAS  Google Scholar 

  19. Maynard SE, Min J-Y, Merchan J, et al. Excess placental sFlt-1 may contribute to endothelial dysfunction, hypertension, and proteinuria in preeclampsia. J Clin Invest 2003; 111 (5): 649–658.

    PubMed  CAS  Google Scholar 

  20. AbdAlla S, Lother H, el Massiery A, Quitterer U. Increased AT(1) receptor heterodimers in preeclampsia mediate enhanced angiotensin II responsiveness. Nat Med 2001; 7 (9): 1003–1009.

    Article  PubMed  CAS  Google Scholar 

  21. Meyer NL, Mercer BM, Friedman SA, Sibai BM. Urinary dipstick protein: a poor predictor of absent or severe proteinuria. Am J Obstet Gynecol 1994; 10: 137–141.

    Google Scholar 

  22. Adelberg AM, Miller J, Doerzbacher M, Lambers DS. Correlation of quantitative protein measurements in 8-, 12-, and 24-hour urine samples for the diagnosis of preeclampsia. Am J Obstet Gynecol 2001; 185: 804–807.

    Article  PubMed  CAS  Google Scholar 

  23. Durnwald C, Mercer B. A prospective comparison of protein/creatinine ratio and 24 hour urine protein in women with suspected preeclampsia. Abstract 569. Am J Obstet Gynecol 2002;187(suppl.)S215.

    Google Scholar 

  24. Friedman SA, Lindheimer MD. Prediction and differential diagnosis. In: Lindheimer M, Cunningham FG, Roberts JM, eds. Chesley’s Hypertensive Disorders in Pregnancy, 2nd ed. Stamford, CT: Appleton & Lange, 1999, pp. 201–227.

    Google Scholar 

  25. Sibai BM. Eclampsia. VI. Maternal-perinatal outcome in 254 consecutive cases. Am J Obstet Gynecol 1990; 163: 1049–1054.

    PubMed  CAS  Google Scholar 

  26. Sibai BM, Taslimi MM, El-Nazer A, et al. Maternal-perinatal outcome associated with the syndrome of hemolysis, elevated liver enzymes, and low platelets in severe preeclampsia-eclampsia. Am J Obstet Gynecol 1986; 155: 501–509.

    PubMed  CAS  Google Scholar 

  27. Lim KH, Friedman SA, Ecker JL, et al. The clinical utility of serum uric acid measurements in hypertensive diseases of pregnancy. Am J Obstet Gynecol 1998; 178: 1067.

    Article  PubMed  CAS  Google Scholar 

  28. Martin JN Jr, Blake PG, Lowry SL, et al. Pregnancy complicated by preeclampsia—eclampsia with the syndrome of hemolysis, elevated liver enzymes, and low platelet count: how rapid is postpartum recovery? Obstet Gynecol 1990; 76: 737–741.

    Article  PubMed  Google Scholar 

  29. van Pampus MG, Wolf H, Ilsen A, et al. Maternal outcome following temporizing management of the (H)ELLP syndrome. Hypertens Pregn 2000; 19: 211–220.

    Article  Google Scholar 

  30. Visser W, Wallenburg HCS. Temporizing management of severe pre-eclampsia with and without the HELLP syndrome. Br J Obstet Gynaecol 1995; 102: 111–117.

    Article  PubMed  CAS  Google Scholar 

  31. Friedman SA, Lubarsky SL, Lim KH. Mild gestational hypertension and preeclampsia. In: Sibai BM, ed. Hypertensive Disorders in Women. Philadelphia: W.B. Saunders, 2001, pp. 9–23.

    Google Scholar 

  32. Sorensen TK, Williams MA, Zingheim RW, Clement SJ, Hickok DE. Elevated second trimester human chorionic gonadotropin and subsequent pregnancy-induced hypertension. Am J Obstet Gynecol 1993; 169: 834–838.

    PubMed  CAS  Google Scholar 

  33. Vaillant P, David E, Constant I, et al. Validity in nulliparas of increased 13-human chorionic gonadotrophin at midterm for predicting pregnancy-induced hypertension complicated with proteinuria and intrauterine growth retardation. Nephron 1996; 72: 557–563.

    Article  PubMed  CAS  Google Scholar 

  34. Ashour AMN, Lieberman ES, Wilkins, Haug LE, Repke JT. The value of elevated second-trimester [3-human chorionic gonadotropin in predicting development of preeclampsia. Am J Obstet Gynecol 1997; 176: 436–442.

    Article  Google Scholar 

  35. Jacobson S-L, Imhof R, Manning N, et al. The value of Doppler assessment of the uteroplacental circulation in predicting preeclampsia or intrauterine growth retardation. Am J Obstet Gynecol 1990; 167: 110–114.

    Google Scholar 

  36. Conde-Agudelo A, Belizan JN, Lede R, Bergel E. Prediction of hypertensive disorders of pregnancy by calcium/creatinine ratio and other laboratory tests [letter]. Int J Gynecol Obstet 1994; 47: 285–286.

    Article  CAS  Google Scholar 

  37. Millar JGB, Campbell SK, Albano JDM, et al. Early prediction of preeclampsia by measurement of kallikrein and creatinine on a random urine sample. Br J Obstet Gynaecol 1996; 103: 421–426.

    Article  PubMed  CAS  Google Scholar 

  38. Kyle P, Redman C, de Swiet M, Millar G. A comparison of the inactive urinary kallikrein:creatinine ratio and the angiotensin sensitivity test for the prediction of preeclampsia [letter reply]. Br J Obstet Gynaecol 1997; 104: 969–974.

    Google Scholar 

  39. Sanchez-Ramos L, Jones DC, Cullen MT. Urinary calcium as an early marker for preeclampsia. Obstet Gynecol 1991; 77: 685–688.

    PubMed  CAS  Google Scholar 

  40. Paarlberg KM, DeJong CLD, Van Geijn HB, et al. Total plasma fibronectin as a marker of pregnancy-induced hypertensive disorders: a longitudinal study. Obstet Gynecol 1998; 91: 383–388.

    Article  PubMed  CAS  Google Scholar 

  41. Konijnenberg A, van der Post JAM, Mol BW, et al. Can flow cytometric detection of platelet activation early in pregnancy predict the occurrence of preeclampsia? a prospective study. Am J Obstet Gynecol 1997; 177: 434–442.

    Article  PubMed  CAS  Google Scholar 

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Authors
  1. Kee-Hak Lim MD
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  2. Melanie M. Watkins MD
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Editor information

Editors and Affiliations

  1. Departments of Pathology and Immunology and Obstetrics and Gynecology, Washington University School of Medicine, and Clinical Chemistry and Serology Laboratories, Barnes-Jewish Hospital, St. Louis, MO, USA

    Ann M. Gronowski PhD, DABCC

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© 2004 Humana Press, Totowa, NJ

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Lim, KH., Watkins, M.M. (2004). Preeclampsia, Eclampsia, and Hypertension. In: Gronowski, A.M. (eds) Handbook of Clinical Laboratory Testing During Pregnancy. Current Clinical Pathology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-59259-787-1_18

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  • DOI: https://doi.org/10.1007/978-1-59259-787-1_18

  • Publisher Name: Humana Press, Totowa, NJ

  • Print ISBN: 978-1-4684-9862-2

  • Online ISBN: 978-1-59259-787-1

  • eBook Packages: Springer Book Archive

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