Advances in the understanding of eclampsia.
Preeclampsia, a serious hypertensive complication of pregnancy characterized by new-onset hypertension and proteinuria after midpregnancy, is a multisystem disorder that often involves the central nervous system. Neurologic signs and symptoms include hyperreflexia, headaches, visual disturbance, seizures, and cerebral hemorrhage. Eclampsia-new-onset seizures in the setting of preeclampsia-usually occurs before or within 48 hours of delivery, but can present as late as 1 month postpartum (late postpartum eclampsia). Magnesium sulfate is the drug of choice to prevent and treat eclampsia, a recommendation validated through large, randomized, and placebo-controlled trials. This review describes the pathogenesis, clinical features, and treatment of eclampsia, focusing on recent observations regarding roles of circulating antiangiogenic factors in the pathogenesis of the neurologic complications of eclampsia.
Karumanchi
S Ananth
SA
University of Chicago, 5841 South Maryland Avenue, MC 5100, Chicago, IL 60637, USA.
Lindheimer
Marshall D
MD
D000927:Anticonvulsants / Q000627:therapeutic use; D015703:Antigens, CD / Q000378:metabolism; D001921:Brain / Q000473:pathology; D001929:Brain Edema / Q000473:pathology; D002560:Cerebrovascular Circulation; D004461:Eclampsia / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology / Q000378:metabolism; D000071063:Endoglin; D005260:Female; D006801:Humans; D008278:Magnesium Sulfate / Q000627:therapeutic use; D011247:Pregnancy; D011505:Protein-Tyrosine Kinases / Q000378:metabolism; D011644:Puerperal Disorders / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology / Q000378:metabolism; D011956:Receptors, Cell Surface / Q000378:metabolism
D000927:Anticonvulsants; D015703:Antigens, CD; C064206:ENG protein, human; D000071063:Endoglin; D011956:Receptors, Cell Surface; D008278:Magnesium Sulfate; D011505:Protein-Tyrosine Kinases