In the 25th week of pregnancy, a G1P0 woman develops increased blood pressure (160/95) and proteinuria. Physical examination demonstrates generalized edema, and serum chemistries demonstrate hyperuricemia and increased concentrations of liver enzymes. Which of the following usually provides definitive therapy for this patient’s medical condition ?
Correct Answer: Delivery
Description: The woman has pre eclampsia, the features of which include proteinuria and increased blood pressure. A wide variety of other features of preeclampsia can also be seen, including excessive weight gain, generalized edema, ascites, hyperuricemia, hypocalciuria, increased plasma concentration of von Willebrand factor and cellular fibronectin, reduced plasma concentration of antithrombin III, thrombocytopenia, increased hematocrit, increased liver enzymes, intrauterine growth retardation, and intrauterine hypoxia. Modern theories suggest that the true primary lesion may involve the endothelium, and that medical control of hypeension actually only treats a small pa of the syndrome. At present, the only definitive therapy is delivery of the baby, and obstetricians often play a delicate game trying to delay delivery for a premature baby's sake as long as possible while judging the severity of the preeclampsia and its immediate risks to mother and fetus. Low dose aspirin may have a modest effect in preventing pre-eclampsia, but this is not yet well established. Oxygen supplementation is used in some cases of cerebral hemorrhage secondary to preeclampsia, but does not constitute definitive therapy. Ref: Cunningham F.G., Leveno K.J., Bloom S.L., Hauth J.C., Rouse D.J., Spong C.Y. (2010). Chapter 34. Pregnancy Hypeension. In F.G. Cunningham, K.J. Leveno, S.L. Bloom, J.C. Hauth, D.J. Rouse, C.Y. Spong (Eds), Williams Obstetrics, 23e.
Category:
Gynaecology & Obstetrics
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