Pre-eclampsia is a disease which occurs during pregnancy and which is characterized by hypertension and proteinuria, or the spilling of protein in the urine.
Hypertension is usually defined as a blood pressure greater than 140 mm Hg systolic or 90 mm Hg diastolic, as confirmed by repeat blood pressure assessments.
Protein in the urine is assessed through urinalysis, and is usually defined as a urine quantity greater than 0.3 grams of protein in a 24-hour specimen.
Many patients with pre-eclampsia also suffer from persistent headaches, visual disturbances, epigastric pain and edema.
In more severe cases, patients with pre-eclampsia may exhibit low blood platelet counts, known as thrombocytopenia.
Although the precise cause of pre-eclampsia remains unknown, it more frequently occurs in patients during their first pregnancy.
Women who suffer from hypertension, diabetes, obesity and those who are of advanced maternal age, greater than 35 years, are also felt to be at increased risk for pre-eclampsia.
Pre-eclampsia is generally classified as being “mild,” “moderate” or “severe”. In many cases, however, a patient with even mild “pre-eclampsia” can rapidly progress to a more severe form of the disease.
Moderate and severe cases of pre-eclampsia can adversely affect numerous maternal organ systems, including the kidney, liver and vasculature.
Undiagnosed or untreated pre-eclampsia can also lead to eclampsia, a potentially deadly consequence associated with significant maternal mortality and potentially permanent neurologic injuries, including intracerebral hemorrhage and blindness.
In cases where pre-eclampsia is undiagnosed or untreated, there are also significant risks to the fetus.
Pre-eclampsia can cause a decrease in the blood flow from the mother’s placenta to the baby, thereby reducing the transfer of oxygen and nutrients to the developing baby.
Thus, in cases of moderate to severe pre-eclampsia, there can be reductions in the amniotic fluid, known as oligohydramnios, intrauterine growth restriction, in which the baby does not grow normally, or placental abruption.
In any patient with pre-eclampsia, prudent obstetrical management is critical to achieve a good outcome for both mother and baby.
Safe and careful obstetricians managing patients with pre-eclampsia will typically conduct through maternal evaluations, including blood and urine laboratory tests, to continually assess the extent of the disease.
Many safe and careful obstetricians will also refer their patients who suffer from pre-eclampsia to maternal-fetal specialists, doctors who have special training and expertise in the management of patients with pre-eclampsia.
In addition to carefully monitoring and treating the mother with pre-eclampsia, safe and careful obstetricians will also initiate a regimen of fetal surveillance to determine what effects the pre-eclampsia may be having on the baby.
Such tests typically will include weekly nonstress tests, biophysical profiles and ultrasound examinations to assess the level of amniotic fluid and to determine whether the baby is growing normally.
Because of the extreme risks associated with even mild to moderate pre-eclampsia, many safe and careful obstetricians deliver their patients prior to term.
The Law Firm of Dugan, Babij, Tolley & Kohler, LLC has extensive experience in representing families whose loved ones have died or been injured as a result of medical malpractice associated with the management of patients with pre-eclampsia.