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Diagnosis and management of atypical preeclampsia-eclampsia

  • Baha M. Sibai
    Correspondence
    Reprints: 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
    Affiliations
    Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Cincinnati College of Medicine, Cincinnati, OH
    Search for articles by this author
  • Caroline L. Stella
    Affiliations
    Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Cincinnati College of Medicine, Cincinnati, OH
    Search for articles by this author
Published:November 19, 2008DOI:https://doi.org/10.1016/j.ajog.2008.07.048
      Preeclampsia, eclampsia, and hemolysis, elevated liver enzymes, and low platelets syndrome are major obstetric disorders that are associated with substantial maternal and perinatal morbidities. As a result, it is important that clinicians make timely and accurate diagnoses to prevent adverse maternal and perinatal outcomes associated with these syndromes. In general, most women will have a classic presentation of preeclampsia (hypertension and proteinuria) at > 20 weeks of gestation and/or < 48 hours after delivery. However, recent studies have suggested that some women will experience preeclampsia without ≥ 1 of these classic findings and/or outside of these time periods. Atypical cases are those that develop at < 20 weeks of gestation and > 48 hours after delivery and that have some of the signs and symptoms of preeclampsia without the usual hypertension or proteinuria. The purpose of this review was to increase awareness of the nonclassic and atypical features of preeclampsia-eclampsia. In addition, a stepwise approach toward diagnosis and treatment of patients with these atypical features is described.

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