Screening and Preeclampsia Diagnostics
Preeclampsia Diagnostics a is diagnosed based on new onset of high blood pressure and protein in the urine after 20 weeks of pregnancy. Blood pressure is considered high if it is 140/90 mm Hg or above on two occasions at least 4 hours apart. Proteinuria is diagnosed if there is 300 mg or more of protein in a urine sample collected over a 24 hour period.
Several tests can help screen for and diagnose preeclampsia. At the first prenatal visit, history is taken including any risk factors like prior preeclampsia, kidney disease, diabetes, etc. Blood pressure is checked at every visit. Starting around 20 weeks, urine is tested at routine visits for protein. Monitoring allows any changes indicative of preeclampsia to be detected early.
Blood Tests
Blood tests can provide additional information to assess risk and monitor Preeclampsia Diagnostics. A complete blood count checks red blood cell and platelet counts which may be low with preeclampsia. Kidney and liver function tests monitor how these organs are handling the condition.
Uric acid and lactate dehydrogenase levels rise with preeclampsia and allow tracking of disease progression. Lower levels correlate with mild disease while very high levels indicate severe preeclampsia mandating close monitoring or delivery.
Another test measures placental growth factor, a protein made by the placenta. Lower second trimester levels point to higher risk of later preeclampsia and allow closer surveillance. After 20 weeks, rising placental growth factor flags impending preeclampsia even before other signs appear.
Ultrasound Exams
Ultrasound assessments are a key part of preeclampsia screening and diagnosis. Starting around 20 weeks, uterine artery Doppler ultrasound checks blood flow in the arteries serving the placenta. Higher resistance is seen in preeclampsia and correlates to increased risk.
Later ultrasounds monitor fetal growth and amniotic fluid volume which may be compromised with severe preeclampsia. They also assess placental function by analyzing blood flow within the placenta on Doppler. Abnormal flow implies the placenta is not working optimally and preeclampsia is more likely.
Biophysical profile ultrasounds provide a non-stress test for fetal wellbeing combining tests like fetal movement, breathing, muscle tone and amniotic fluid volume into a score. Low scores in late pregnancy may prompt delivery for preeclampsia concerns.
Continued Monitoring and Delivery Timing
Management depends on gestational age and severity once preeclampsia is diagnosed. Patients with mild disease and before 37 weeks may be monitored closely as an outpatient with serial visits and testing. Severe preeclampsia requires hospitalization for very close oversight, possible magnesium sulfate treatment and delivery planning.
If preeclampsia arises before 37 weeks but is stable, steroids may be given and expectant management tried until 37 weeks when risk of complications is lower. Beyond 37 weeks, delivery is often advised for severe preeclampsia or if testing raises safety concerns for mom or baby. Postpartum care monitors resolution of symptoms and identifies any longer term effects.
Multidisciplinary Approach
An integrated team approach improves preeclampsia diagnosis and management. Maternal-fetal medicine specialists, OB-GYNs, midwives, nurses, and technicians each contribute expertise through screening, testing, risk evaluation and delivery timing decisions.
guidelines are followed but individualized management respects each patient’s circumstances. Ongoing research advances early detection to improve outcomes for mothers and babies affected by this serious pregnancy complication.
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