American Journal of Obstetrics & Gynecology
Volume 200, Issue 5 , Pages 481.e1-481.e7 , May 2009

Diagnosis and management of atypical preeclampsia-eclampsia

  • Baha M. Sibai, MD

      Affiliations

    • Corresponding Author InformationReprints: Baha M. Sibai, MD, Division of Maternal-Fetal Medicine, University of Cincinnati, 231 Albert Sabin Way, Room 5052, Medical Sciences Building, PO Box 670526, Cincinnati, OH 45267-0526
    • ,
  • Caroline L. Stella, MD

Received 4 June 2008 ,Revised 2 July 2008 ,Accepted 28 July 2008.

References 

  1. Report of the National High Blood Pressure Education Program Working Group. Report on high blood pressure in pregnancy. Am J Obstet Gynecol. 2000;183:S1–S22
  2. Sibai BM. Diagnosis and management of gestational hypertension and preeclampsia. Obstet Gynecol. 2003;102:181–192
  3. ACOG Committee on Practice Bulletins-Obstetrics. Diagnosis and management of preeclampsia and eclampsia. Obstet Gynecol. 2001;98:159–167
  4. Hauth JC, Ewell MG, Levine RL, Esterlitz JR, Sibai BM, Curet LB. Pregnancy outcomes in healthy nulliparous women who subsequently developed hypertension: calcium for preeclampsia prevention study group. Obstet Gynecol. 2000;95:24–28
  5. Brown MA, Hague WM, Higgins J, et al. The detection, investigation, and management of hypertension in pregnancy: full consensus statement of recommendations from the Council of Australian Society of the study of hypertension in pregnancy. Aust N Z J Obstet Gynaecol. 2000;40:139
  6. Brown MA, Lindheimer MD, de Swiet M, Van Assche A, Moutquin JM. The classification and diagnosis of the hypertensive disorders of pregnancy: statement of the International Society for the study of hypertension in pregnancy (ISSHP). Hypertens Pregnancy. 2001;20:IX–XIV
  7. Mattar F, Sibai BM. Eclampsia VIII: risk factors for maternal morbidity. Am J Obstet Gynecol. 2000;182:307–312
  8. Sibai BM. Diagnosis, controversies and management of the HELLP syndrome. Obstet Gynecol. 2004;103:981–991
  9. Sibai BM. Diagnosis, differential diagnosis and management of eclampsia. Obstet Gynecol. 2005;105:402–410
  10. Brown MA, Buddle ML. Hypertension in pregnancy: maternal and fetal outcomes according to laboratory and clinical features. Med J Aust. 1996;165:360–365
  11. Knight M UKOSS. Eclampsia in the United Kingdom 2005. BJOG. 2007;114:1072–1078
  12. Airoldi J, Weinstein L. Clinical significance of proteinuria in pregnancy. Obstet Gynecol Surv. 2007;62:117–124
  13. Barton JR, O'Brien JM, Bergauer NK, Jacques DL, Sibai BM. Mild gestational hypertension remote from term: progression and outcome. Am J Obstet Gynecol. 2001;184:979–983
  14. Saudan P, Brown MA, Buddle ML, Jones M. Does gestational hypertension become preeclampsia?. BJOG. 1998;105:1177–1184
  15. Magee LA, von Dadelszen P, Bohun CM, et al. Serious perinatal complications of non-proteinuric hypertension: an international, multicentre, retrospective cohort study. J Obstet Gynaecol Can. 2003;2:372–382
  16. Buchbinder A, Sibai BM, Caritis S, Macpherson C, Hauth J, Lindheimer MD. Adverse perinatal outcomes are significantly higher in severe gestational hypertension than in mild preeclampsia. Am J Obstet Gynecol. 2002;186:66–71
  17. Sibai BM, Barton JR. Expectant management of severe preeclampsia remote from term: patient selection, treatment, and delivery indications. Am J Obstet Gynecol. 2007;196:514.e1–514.e9
  18. Martin JN, Rose CH, Briery CM. Understanding and managing HELLP syndrome: the integral role of aggressive glucocorticoids for mother and child. Am J Obstet Gynecol. 2006;195:914–934
  19. Levine RJ, Ewell MG, Hauth JC, et al. Should the definition of preeclampsia include a rise in diastolic blood pressure of ≥15 mm Hg to a level of <90 mm Hg in association with proteinuria?. Am J Obstet Gynecol. 2000;183:787–792
  20. Villar J, Abdel-Aleem H, Merialdi M, et al. World Health Organization randomized trial of calcium supplementation among low calcium intake pregnant women. Am J Obstet Gynecol. 2006;194:639–649
  21. Masuyama H, Suwaki N, Nakatsukasa H, et al. Circulating angiogenic factors in preeclampsia superimposed on chronic glomerulonephritis. Am J Obstet Gynecol. 2006;194:551–556
  22. Holston A, Qian C, Karumanchi A, Yu K, Levine R. Circulating angiogenic factors in gestational proteinuria without hypertension. Am J Obstet Gynecol. 2007;197:S134
  23. Baker AM, Morey MK, Berg KK, Crosson J. Trophoblastic microemboli as a marker for preeclampsia-eclampsia in sudden unexpected maternal death: a case report and review of the literature. Am J Forensic Med Pathol. 2000;21:354–358
  24. Murakami S, Saitoh M, Kubo T, Koyama T, Kobayashi M. Renal disease in women with severe preeclampsia or gestational proteinuria. Obstet Gynecol. 2000;96:945–949
  25. Rahimpanah F, Smoleniec J. Partial mole, triploidy and proteinuric hypertension: two case reports. Aust N Z J Obstet Gynaecol. 2000;40:215–218
  26. Stefos T, Plachouras N, Mari G, Cosmi E, Lolis D. A case of partial mole and atypical type I triploidy associated with severe HELLP syndrome at 18 weeks' gestation. Ultrasound Obstet Gynecol. 2002;20:403–404
  27. Sherer DM, Dalloul M, Stimphil R, et al. Acute onset of severe hemolysis, elevated liver enzymes, and low platelet count syndrome in a patient with partial hydatidiform mole at 17 weeks gestation. Am J Perinatol. 2006;23:163–166
  28. Haram K, Trovik J, Sandset PM, Hordnes K. Severe syndrome of hemolysis, elevated liver enzymes and low platelets (HELLP) in the 18th week of pregnancy associated with the antiphospholipid-antibody syndrome. Acta Obstet Gynecol Scand. 2003;82:679–680
  29. Bornstein E, Barnhard Y, Atkin R, Divon M. HELLP syndrome: a rare, early presentation at 17 weeks of gestation. Obstet Gynecol. 2007;110:525–527
  30. Hazra S, Waugh J, Bosio P. “Pure” preeclampsia before 20 weeks of gestation: a unique entity. BJOG. 2003;110:1034–1035
  31. Sibai BM. Imitators of severe preeclampsia. Obstet Gynecol. 2007;109:956–966
  32. Geerts L, Odendaal HJ. Severe early onset pre-eclampsia: prognostic value of ultrasound and Doppler assessment. J Perinatol. 2007;27:335–342
  33. Li H, Gudnason H, Olofsson P, Dubid M, Gudmundsson S. Increased uterine artery vascular impedance related to adverse outcome of pregnancy but is present in only one-third of late third-trimester preeclamptic women. Ultrasound Obstet Gynecol. 2005;25:459–463
  34. Lubarsky SL, Barton JR, Friedman SA, Nasreddine S, Ramaddan MK, Sibai BM. Late postpartum eclampsia revisited. Obstet Gynecol. 1994;83:502–505
  35. Mathys LA, Coppage KH, Lambers DS, Barton JR, Sibai BM. Delayed postpartum preeclampsia: an experience of 151 cases. Am J Obstet Gynecol. 2004;190:1464–1466
  36. Tan LK, de Swiet M. The management of postpartum hypertension. BJOG. 2002;109:733–738
  37. Douglas KA, Redman CW. Eclampsia in the United Kingdom. BMJ. 1994;308:1395–1400
  38. Conde-Agudelo A, Kafury-Goeta AC. Epidemiology of eclampsia in Colombia. Int J Gynaecol Obstet. 1998;61:1–8
  39. Katz V, Farmer R, Kuller JA. Preeclampsia into eclampsia: toward a new paradigm. Am J Obstet Gynecol. 2000;182:1389–1396
  40. Chames MC, Livingston JC, Ivester TS, Barton JR, Sibai BM. Late postpartum eclampsia: a preventable disease?. Am J Obstet Gynecol. 2002;186:1174–1177
  41. Chen CY, Kwek K, Tan KH, Yeo GS. Our experience with eclampsia in Singapore. Singapore Med J. 2003;44:88–93
  42. Stella CL, Jodicke C, Harkness U, How HY, Sibai BM. Postpartum headache: is your work-up complete?. Am J Obstet Gynecol. 2007;196:318.e1–318.e7
  43. Neudecker S, Stock K, Krasnianski M. Call-Fleming postpartum angiopathy in the puerperium: a reversible cerebral vasoconstriction syndrome. Obstet Gynecol. 2006;107:446–449
  44. Fonseca JE, Mendez F, Catano C, Arias F. Dexamethasone treatment dose not improve the outcome of women with HELLP syndrome: a double-blind, placebo-controlled, randomized clinical trial. Am J Obstet Gynecol. 2005;193:1591–1598
  45. Katz L, de Amorim MMM, Figueiro JN, Pinto e Sliva JL. Postpartum dexamethasone for women with hemolysis, elevated liver enzymes, and low platelets (HELLP) syndrome: a double-blind, placebo-controlled, randomized clinical trial. Am J Obstet Gynecol. 2008;198:283.e1–283.e8
  46. Sibai BM, Barton JR. Dexamethasone to improve maternal outcome in women with hemolysis, elevated liver enzymes, and low platelets syndrome. Am J Obstet Gynecol. 2005;193:1587–1590
  47. Lattuada RJ, Rossi E, Calzarossa C, Candolfi R, Mannucci PM. Mild to moderate reduction of a von Willebrand factor cleaving protease (ADAMTS-13) in pregnant women with HELLP microangiopathic syndrome. Haematologica. 2003;88:1029–1034
  48. Levine RJ, Lam C, Qian C. Soluble endoglin and other circulating angiogenic factors in preeclampsia. N Engl J Med. 2006;355:992–1005
  49. Levine RJ, Maynard SE, Qian C, et al. Circulating angiogenic factors and the risk for preeclampsia. N Engl J Med. 2004;350:672–683
  50. Salahuddin S, Lee Y, Vadnais M. Diagnostic utility of soluble fms-like tyrosine kinase 1 and soluble endoglin in hypertensive diseases of pregnancy. Am J Obstet Gynecol. 2007;197:28.e1–28.e6
  51. Robinson CJ, Johnson DJ. Soluble endoglin as a second-trimester marker for preeclampsia. Am J Obstet Gynecol. 2007;197:174.e1–174.e6

 Cite this article as: Sibai BM, Stella CL. Diagnosis and management of atypical preeclampsia-eclampsia. Am J Obstet Gynecol 2009;200:481.e1-481.e7.

PII: S0002-9378(08)00866-1

doi: 10.1016/j.ajog.2008.07.048

American Journal of Obstetrics & Gynecology
Volume 200, Issue 5 , Pages 481.e1-481.e7 , May 2009

Article Tools

* Image Usage & Resolution