Preeclampsia: Diagnosis, Treatment and Management

Preeclampsia is becoming an increasingly common diagnosis in the developed world and remains a high cause of maternal and fetal morbidity and mortality in the developing world. It is a multisystem progressive disorder of pregnancy characterized by the new onset of hypertension and proteinuria of mg/day or of hypertension and significant end-organ dysfunction with or without proteinuria. It also presents with a variety of organ failures, including malfunction of kidneys, liver and lungs. It is estimated that about 5-7% of pregnancies are complicated by preeclampsia. This disorder always resolves after delivery. In about 80% of cases, pregnancy ends with good maternal and fetal outcomes. However, these pregnancies are still at increased risk for maternal and/or fetal mortality or serious morbidity. The remaining 20% of cases are at risk for preterm delivery and small gestational age infant. As regards the long-term consequences, women with preeclampsia are at high risk for cardiovascular, renal, and chronic hypertensive diseases. The exact pathophysiology of preeclampsia is poorly understood and, consequently, there are no well-established methods of primary prevention or of cost-effective screening. Childbirth is the only known cure; however, the decision between delivery and expectant management depends on several factors, such as fetal gestational age, maternal and fetal status at time of initial evaluation, presence of labor or rupture of fetal membranes, and level of available neonatal and maternal services. The aim of this book is to provide an overview of the latest developments about the physiopathology, diagnosis, and treatment of pre-eclampsia. Addressed to gynecologists, obstetricians, researchers and students, this text aims to become a reference for all operators who are interested in pregnancy complications and in the management and treatment of this specific disorder which is increasingly common in the population.