Preeclampsia Complications: Update

Abstract

This update defines complications of preeclampsia starting with changes in definition that include 6 target organs including pulmonary edema and Uteroplacental dysfunction.

In eclampsia its pathophysiology is specified as a loss of self-regulation of cerebral blood flow, edema and possible hemorrhage, magnesium sulfate schemes are presented and its unproven need in the postpartum period is defined.

In acute pulmonary edema, the 3 causes are contemplated such as increased pressure, overhydration and endothelial damage, sometimes requiring diuretics and sometimes intubation in the management.

In hepatic rupture, its etiology is specified that begins with extravasation endothelial damage of red blood cells, thrombosis, hemorrhage, hematoma formation and its rupture. It specifies the segments of the right lobe as the most compromised, the accuracy of the degree of liver damage with two classifications and its multiple management based on liver packing.

In HELLP syndrome, its etiology is specified as the sum of the hepatic and hematological involvement, the need to specify the degrees of severity and it is shown that its presence more of early origin aggravates the other complications. The benefits of dexamethasone in its management are mentioned.

In acute kidney injury, the etiology shows not only glomeruloendotheliosis but also podocituria and microangiopathic thrombosis, the presence of hematuria as a sign of alarm, the criteria of the AKI stages 1, 2 and 3 of the last classification and its management with replacement therapy and hemodialysis.

Finally, in placental uterine involvement, the latest definitions of o fetal growth restriction are specified, which is a data of severity of preeclampsia and that taking into account the criterion prevents perinatal mortality significantly than when it is not considered as a criterion.