Disease Name Confirmation
Preeclampsia (Pre-eclampsia) — This is the medically accepted term. It is characterized by hypertension and proteinuria (or indicators of organ damage) occurring after 20 weeks of pregnancy.
1) Disease Description (Causes and Symptoms)
- Definition: A condition involving elevated blood pressure occurring after 20 weeks of pregnancy (systolic ≥140 mmHg or diastolic ≥90 mmHg) and proteinuria (24-hour protein ≥300 mg or protein/creatinine ratio ≥0.3), or, even without proteinuria, indicators of organ damage such as thrombocytopenia, elevated liver enzymes, impaired kidney function, pulmonary edema, or central nervous system abnormalities.
- Pathophysiology: Poor invasion of the embryonic trophoblast (trophoblastic cells) leading to abnormal placental vascular formation → placental ischemia → systemic vascular endothelial dysfunction, vasoconstriction, and an inflammatory response.
- Main symptoms:
- Uncommon (asymptomatic in the early stages) — Regular prenatal checkups are important
- Headache (when severe), visual disturbances (seeing halos, blurred vision), upper abdominal/right upper quadrant pain (liver ischemia), decreased urine output, generalized edema, decreased fetal movement
- Risk factors: First pregnancy, history of preeclampsia, chronic hypertension, diabetes·obesity, multiple pregnancy, advanced maternal age, kidney disease, autoimmune disease, etc.
2) Treatment (Standard Treatment·Medications·Procedures/Surgery·Lifestyle Management and Precautions)
- Definitive treatment: Delivery (removal of the fetus and placenta) is the only definitive treatment.
- Management principles:
- Mild cases (without severe symptoms or signs of organ damage): Expectant (watchful waiting) management may be possible until fetal maturity while frequently monitoring the condition of the mother and fetus, blood pressure, and test results.
- Severe cases (severe features: blood pressure ≥160/110 mmHg, impaired kidney/liver function, platelets <100,000/µL, pulmonary edema, persistent central nervous system symptoms, etc.): Immediate delivery should be considered (with preparation for a safe delivery whenever possible).
- Medication treatment:
- Prevention of seizures (eclampsia): Administration of magnesium sulfate (standard regimen: a loading dose followed by maintenance therapy; administration should take place during hospitalization under medical supervision).
- Emergency treatment of hypertension (severe hypertension): IV labetalol, IV hydralazine, oral/extended-release nifedipine, etc. The goal is to avoid a rapid drop in blood pressure; specific immediate-treatment criteria follow local guidelines.
- When preterm delivery is expected, administration of steroids (betamethasone/dexamethasone) may be considered for fetal lung maturation (mainly when preterm delivery before 34 weeks is expected).
- Contraindication: ACE inhibitors and ARBs must not be used during pregnancy because of the risk of harm to the fetus.
- Lifestyle management:
- Regular blood pressure/weight/proteinuria testing and immediate reporting of symptoms (severe headache·visual disturbances·upper abdominal pain·shortness of breath·decreased fetal movement, etc.).
- Hospital observation is often necessary (especially in severe or rapidly progressing cases).
- Prevention:
- For high-risk individuals, low-dose aspirin (generally 75–150 mg/day) is recommended from around 12 weeks of pregnancy until delivery (according to national guidelines).
- Calcium supplementation is recommended in areas where calcium intake is low.
- Weight management and appropriate management of diabetes and hypertension.
- Risk of complications·Precautions:
- If symptoms requiring immediate emergency treatment occur (severe headache·visual disturbances·persistent upper abdominal pain·shortness of breath·bleeding, etc.), visit an emergency department.
- Blood pressure and kidney function must also be monitored after delivery (the condition may persist for several days to several weeks after delivery).
- Increased long-term risk of cardiovascular disease and hypertension.
3) Checklist Before an Outpatient Visit (Including Items to Bring and Example Questions)
- Items and records to prepare:
- List of medications currently being taken (including prescriptions·OTC medications·supplements)
- Medical history (chronic hypertension, kidney disease, diabetes, history of preeclampsia, etc.) and outcomes of previous pregnancies
- Recent blood pressure records (including home measurements) — if possible, include the date·time·measurement
- Records of weight changes, changes in urine output, and degree of edema
- Timing of symptom onset and changes (headache·visual disturbances·abdominal pain·fetal movement, etc.)
- Copies of recent test results (urinalysis, blood tests, ultrasound findings, etc.)
- Information to tell the doctor in advance during the outpatient visit:
- Whether acute symptoms have occurred (e.g., sudden loss of vision, severe headache, bleeding, etc.)
- High blood pressure readings measured at home or problems related to taking medications
- Example questions (for the doctor):
- "Do my current blood pressure and test results meet the criteria for preeclampsia?"
- "Is hospitalization necessary, or should delivery be considered immediately?"
- "Are the medications I am taking safe during pregnancy?"
4) Examples of General Questions to Ask the Doctor
- "Given my current condition, when should delivery be considered?"
- "What are the main side effects and precautions of this medication (or treatment)?"
- "How likely is it that my blood pressure will remain elevated after delivery?"
- "What can I do to reduce the risk of recurrence in my next pregnancy?"
5) Examples of Disease-Specific Questions
- "Considering my blood pressure (or blood test results) and the condition of the fetus, can I be safely managed with expectant management (continued observation), or would you recommend preterm delivery?"
- "I am taking (specific medication name) during pregnancy. Is it safe to continue taking it before and after delivery? Are there any medications I need to change?"
Note: The information above is general medical information. Diagnosis and treatment based on an individual's condition should be decided in consultation with an obstetrician-gynecologist.