complications of eclampsia
DESCRIPTION
Complications of eclampsiaTRANSCRIPT
Complications of Eclampsia
-K.Mohan Ram
MATERNAL• Placental abruption —10 percent
• Neurological deficits —7 percent
• Aspiration pneumonia —7 percent
• Pulmonary edema —5 percent
• Cardiovascular problems —4 percent
• Acute renal failure —4 percent
• Death —1 percent
FETAL
• Prematurity
• IUGR
• Hematological changes
• Broncho Pulmonary disease
• Neurodevelopmental Outcome
• Fetal Origins of Adult Disease States
Placental abruption
Coagulopathy
increased factor VIII consumption
increased levels of fibrinopeptides A and B
increased levels of fibrin degradation
products
decreased levels of regulatory proteins
(antithrombin III, protein C,
protein S)
Coagulation aberrations found in eclampsia
THROMBOCYTOPENIA
• Routine laboratory assessment (PT, APTT, p.fibrinogen level) – unnecessary.
ECLAMPSIANO PLACENTAL
ABRUPTION
ECLAMPSIAPLACENTAL ABRUPTION
Neurological deficits
perivascularedema
cerebral infarctions
subjectively impaired cognitive
functioning
Pulmonary edema
Pulmonary edema
alveolar endothelial-
epithelial leak
ventricular failure
aspiration pneumonia
Cardiovascular problems
Eclampsia
Metabolic syndrome
Diabetes
Obesity
Dyslipidemia
Atherosclerosis
ischemic heart
disease
stroke
chronic hypertensio
n
Acute renal failure
Renal pathology is both endothelial and epithelial
Eclampsia
HELLPsyndrome
placental abruption
hemorrhagic hypotension Acute tubular
necrosis
Renal cortical necrosis
Death
hypertensive disorders
Renal failure
Hemorrhagic disorders
Cerebrovascular haemorrhage
Cardio-pulmonary failure
DIC
Sepsis
IUGRHematological
changesPrematurity
Broncho pulmonary
disease
Neuro developmental
problems
Fetal origin of adult diseases
IUGR
Eclampsia
Uteroplacental insufficiency
IUGR
Hematological changes
PREMATURITY
Increased oxidative stress
Broncho pulmonary disease
Vascular hypothesis of BPD
Neurodevelopmental Outcome
Decreased risk of cerebral palsy
Lower incidence of IVH
Lower MDI scores
Fetal Origins of Adult Disease States
Hypertension Obesity
DiabetesCardiovascular
morbidity
References
Williams-Obstetrics - 23rd-Edition
The causes of maternal deaths in eclampsia in Lagos, Nigeria. Odum CU, Akinkugbe A. West Afr J Med. 1991 Jan-Mar;10(1):371-6.
PMID: 2069883 [PubMed - indexed for MEDLINE]
Journal of PregnancyVolume 2011 (2011), Article ID 214365, 7 pages
doi:10.1155/2011/214365
Preeclampsia: Effect on the Fetus and Newbornde Souza Rugolo, et al. Neoreviews 2011; 12:e198-e206