Preeclampsia and Eclampsia Revisited

Sherri A. Longo, MD; Chi P. Dola, MD; Gabriella Pridjian, MD


South Med J. 2003;96(9) 

In This Article

Preeclampsia Superimposed on Chronic Hypertension

Approximately 25% of women with preexisting hypertension who become pregnant develop superimposed preeclampsia.[69] Superimposed preeclampsia is especially increased in women with chronic severe hypertension and in women with preexisting cardiovascular or renal disease.[70] The diagnosis of superimposed preeclampsia may be difficult in women with preexisting proteinuria as a result of renal disease. This diagnosis should be suspected if there is a sudden increase in proteinuria or hypertension, thrombocytopenia develops, or liver enzyme levels are abnormal in women with chronic hypertension after 20 weeks' gestation. Women with preeclampsia superimposed on chronic hypertension are at higher risk for poor perinatal outcome and placental abruption.[71,72] Underlying end organ disease such as left ventricular hypertrophy or cardiac dysfunction predisposes them to more frequent and more serious complications.


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