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| * [[limbs]] [[pitting swelling]] | | * [[limbs]] [[pitting swelling]] |
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| | | :* [[Posterior reversible encephalopathy syndrome]] should be considered in the setting of [[preeclampsia]] in patients with [[vision loss]] or [[deficit]], [[seizure]], [[headache]], and [[altered sensorium]] or [[confusion]]. |
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| Nervous system manifestations frequently encountered
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| in preeclampsia are headache, blurred vision,
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| scotomata, and hyperreflexia. Although uncommon,
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| temporary blindness (lasting a few hours to as long as
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| a week) also may accompany preeclampsia with severe
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| features and eclampsia (47). Posterior reversible encephalopathy
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| syndrome (PRES) is a constellation of a range | |
| of clinical neurologic signs and symptoms such as vision
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| loss or deficit, seizure, headache, and altered sensorium
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| or confusion (48). Although suspicion for PRES is
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| increased in the setting of these clinical features, the
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| diagnosis of PRES is made by the presence of vasogenic
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| edema and hyperintensities in the posterior aspects of the
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| brain on magnetic resonance imaging. Women are particularly
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| at risk of PRES in the settings of eclampsia and
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| preeclampsia with headache, altered consciousness, or
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| visual abnormalities (49). Another condition that may
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| be confused with eclampsia or preeclampsia is reversible
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| cerebral vasoconstriction syndrome (50). Reversible
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| cerebral vasoconstriction syndrome is characterized by
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| reversible multifocal narrowing of the arteries of the
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| brain with signs and symptoms that typically include
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| thunderclap headache and, less commonly, focal neurologic
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| deficits related to brain edema, stroke, or seizure.
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| Treatment of women with PRES and reversible cerebral
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| vasoconstriction syndrome may include medical control
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| of hypertension, antiepileptic medication and long-term
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| neurologic follow-up.
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| Patients with [[preeclampsia usually appear [[general appearance]].
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| Physical examination may be remarkable for:
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| [finding 1] | |
| [finding 2] | |
| [finding 3]
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| [finding 4] | |
| [finding 5] | |
| [finding 6]
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| Pre-eclampsia is diagnosed when a [[pregnancy|pregnant]] woman develops high blood pressure (two separate readings taken at least 6 hours apart of 140/90 or more). A rise in baseline BP of 20 systolic or 15 diastolic, while not meeting the absolute criteria of 140/90 is still considered important to note but no longer diagnostic. Swelling, or [[edema]], (especially in the hands and face) was originally considered an important sign for a diagnosis of pre-eclampsia, but in current medical practice, only [[hypertension]] and [[proteinuria]] are necessary for a diagnosis. However, unusual swelling, particularly of the hands, feet, or face, notable by leaving an indentation when pressed on, can be significant and should be reported to the health-care provider.
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| ==References== | | ==References== |