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Pre-eclampsia (previously called toxemia) is a hypertensive disorder of pregnancy. It is said to exist when a pregnant woman with gestational hypertension develops proteinuria. Originally, edema was considered part of the syndrome of pre-eclampsia, but presently the former two symptoms are sufficient for a diagnosis of pre-eclampsia.
Pre-eclampsia is much more common in the first pregnancy (3-5% of births) and usually becomes evident in the third trimester (and virtually always after the 20th week of pregnancy).
Pre-eclampsia is thought to be caused by inflammatory mediators secreted by the placenta and acting on the vascular endothelium. If severe, it progresses to fulminant pre-eclampsia, with headaches and visual disturbances, and further to HELLP syndrome and eclampsia. These are life threatening conditions, not only for the developing fetus but for the mother as well.
The only treatment for eclampsia, or advancing pre-eclampsia is delivery, either by induction or Caesarean section. Women can be stabilized temporarily with magnesium sulphate. Delivery as early as 28 weeks is not unknown.
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