Definition

Preeclampsia: new-onset gestational hypertension with proteinuria or end-organ dysfunction
- Superimposed preeclampsia: preeclampsia that occurs in a patient with chronic hypertension
- HELLP syndrome
  - A life-threatening form of preeclampsia characterized by Hemolysis, Elevated Liver enzymes, and Low Platelets
  - May occur without hypertension or proteinuria
- Occurrence of new-onset hypertension, proteinuria, or end-organ dysfunction at < 20 weeks’ gestation is suggestive of gestational trophoblastic disease.
Eclampsia: new-onset seizures (tonic-clonic, focal, or multifocal) in the absence of other causes ; a convulsive manifestation of hypertensive pregnancy disorders

Epidemiology

Indications
- Eclampsia
- HELLP syndrome
- Preeclampsia with severe features
Administration: magnesium sulfate (IV or IM)
- Contraindicated in patients with myasthenia gravis
- Should be administered with care in patients with renal insufficiency
Monitoring
- Monitor all patients for signs of hypermagnesemia (e.g., decreased deep tendon reflexes, respiratory depression).
- Signs of hypermagnesemia: Administer calcium gluconate (see “Hypermagnesemia” for clinical features and more information on management of hypermagnesemia).

Indications
- ≥ 1 high-risk feature or ≥ 2 moderate-risk factors for preeclampsia.
Regimen
- Initiate low-dose aspirin between 12–20 weeks’ gestation (optimally before 16 weeks)