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Pathophysiology and management of pre-eclampsia, eclampsia, and HELLP syndrome 

Pathophysiology and management of pre-eclampsia, eclampsia, and HELLP syndrome
Pathophysiology and management of pre-eclampsia, eclampsia, and HELLP syndrome

Muna Noori

and Catherine Nelson-Piercy

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date: 18 May 2022

Pre-eclampsia is a multisystem disorder of pregnancy, characterized by the gestational onset of hypertension and proteinuria, which presents as part of a spectrum of disease with potentially serious consequences for both mother and foetus. Pre-eclampsia is a syndrome with multiple aetiologies, which has made it difficult to develop adequate screening tests and treatments. Pre-eclampsia is likely to develop only in vulnerable women with a mix of genetic susceptibility, vascular, metabolic, and inflammatory dysfunction. A number of prepregnancy risk factors for pre-eclampsia have been identified. However, not all women with risk factors develop pre-eclampsia, while many women without do, making it a challenging condition to predict. As pre-eclampsia cannot be prevented, its management remains supportive, with close monitoring of clinical signs and symptoms, antihypertensive therapy, seizure prophylaxis, and ultimately delivery when necessary. This chapter outlines the pathophysiology, diagnosis, and sequelae of pre-eclampsia, and provides an overview of antenatal, intrapartum, and post-natal management of women with pre-eclampsia.

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