Pre-eclampsia toxaemia

Abstract

A 33 year old primagravida rhesus positive woman was referred to the Emergency Department by her family doctor at 27 weeks gestation. At 25 weeks of gestation, she had been diagnosed with hypertension and was started on labetalol therapy. At 27 weeks of gestation she was admitted in view of persistently raised blood pressure which was not being controlled with Labetalol, generalised (facial, hands and lower limbs) oedema and frequent frontal headaches. The patient also complained of photophobia. Following examination it was found that the patient was suffering from pre-eclampsia toxaemia. Delivery was expedited in view of the developing complications. Pre-eclampsia toxaemia is a multi-system disorder which manifests as hypertension and proteinuria after 20 weeks of gestation. The disease originates from the placenta and is cured by delivery. There is blood vessel endothelial damage with a maternal inflammatory response which leads to vasospasm, increased capillary permeability and clotting dysfunction which account for hypertension, proteinuria, reduced placental blood flow and reduced cerebral perfusion resulting in eclampsia.