2022, Number 05
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Ginecol Obstet Mex 2022; 90 (05)
Atypical preeclampsia: on the subject of a case
Caicedo DA, Mesa L, Robles M, García-Agudelo L, Vargas-Rodríguez LJ
Language: Spanish
References: 15
Page: 456-460
PDF size: 183.87 Kb.
ABSTRACT
Background: Preeclampsia before 20 weeks' gestation is exceptional; it is associated
with antiphospholipid syndrome. Hypertensive disorder of pregnancy is the leading
cause of maternal and perinatal mortality worldwide, represents a 10% complication
of all the pregnancies worldwide, where there has been a significant increase in its
incidence has been observed. In the last two decades, with an annual estimate of
50,000 to 60,000 maternal deaths in the world.
Clinical case: 26-year-old woman in the 17th week of pregnancy, who was admitted
to the emergency department for a 20-minute evolution of severe headache with
subsequent generalized tonic-clonic seizure episode, admission blood pressure was
170/102 mmHg, she was also found with mucocutaneas pallor, gynecological examination
found a gravid uterus with a uterine height of 18 cm, and a fetal heart rate of
136 bpm. The paraclinical tests confirmed a HELLP syndrome, being considered an
atypical situation due to the gestational age in which she presented.
Conclusions: Atypical cases of preeclampsia are usually rare cases, especially
when they appear before week 20; however, in this population it is important to make
a diagnosis process in a timely manner, to initiate rapid treatment. Additionally, caution
should be exercised with disorders including lupus nephritis, thrombotic thrombocytopenic
purpura, and hemolytic uremic syndrome, as well as molar pregnancy and
antiphospholipid syndrome.
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