الفهرس | Only 14 pages are availabe for public view |
Abstract The hypertensive diseases of pregnancy remain a leading cause of maternal deaths. Maternal morbidity and mortality may be secondary to the preeclamptic disease process. Mortality rates are highest when the disease presents at early gestations (20–28 weeks), with advanced maternal age or after the first live birth. Women of Afro-Caribbean decent are three times as likely to die from preeclamptic complications or eclampsia when compared with Caucasian women. Although patients with pre-eclampsia are hypovolemic, their tissues are fluid-overloaded and they have increased sensitivity to volume shifts. This is a consequence of low plasma oncotic pressure, raised hydrostatic pressure due to hypertension and increased capillary permeability reflecting endothelial dysfunction. To reduce the chances of complications (pulmonary edema, left ventricular failure and adult respiratory distress syndrome), close monitoring of the fluid balance is essential. |