PREECLAMPSIA ,definition,features,diagnosis and management

Preeclampsia is a multisystem progressive disorder characterized by the new onset of hypertension and proteinuria, or of hypertension and significant end-organ dysfunction with or without proteinuria, in the last half of pregnancy or postpartum

The disorder is caused by placental and maternal vascular dysfunction and always resolves after delivery.
Although most affected pregnancies deliver at term or near term with good maternal and fetal outcomes, these pregnancies are at increased risk for maternal and/or fetal mortality or serious morbidity

Risk factors for pre-eclampsia include obesity, prior hypertension, older age, gestational diabetes, and diabetes mellitus.
It is also more frequent in a woman's first pregnancy and if she is carrying twins.
The underlying mechanism involves abnormal formation of blood vessels in the placenta amongst other factors.
 Most cases are diagnosed before delivery. Rarely, pre-eclampsia may begin in the period after delivery.
While historically both high blood pressure and protein in the urine were required to make the diagnosis, some definitions also include those with hypertension and any associated organ dysfunction.
Blood pressure is defined as high when it is greater than 140 mmHg systolic or 90 mmHg diastolic at two separate times, more than four hours apart in a woman after twenty weeks of pregnancy.