Gynecology And Obstetrics Chapter 252. Development of hypertension with albuminuria or edema between the 20th wk of pregnancy and the end of the 1st week postpartum. The etiology of preeclampsia and eclampsia is unknown. If untreated, preeclampsia characteristically smolders for a variable time, then suddenly progresses to eclampsia. Eclampsia develops in 1 of 200 patients with preeclampsia and is usually fatal if untreated.
Mild preeclampsia develops as borderline hypertension, unresponsive edema, or albuminuria.
BUN and creatinine levels should be obtained to rule out unsuspected kidney disease. A patient with early signs of mild preeclampsia may be treated as an outpatient requiring strict bed rest, but she should be seen by her physician every 2 days. If her condition does not immediately improve, she should be hospitalized. Once the decision to treat preeclampsia with more than bed rest has been made, delivery should be the objective. No data indicate that delay in delivery enhances neonatal survival, except when patients have unusually mild and immediately responsive preeclampsia and delivery would be premature.