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Abstract
In general, the term "preeclampsia" refers to the presence of hypertension associated with proteinuria occurring after 20 weeks of gestation in a previously non-proteinuric and normotensive woman. A 24-year-old woman, known to be non-hypertensive, carried two pregnancies and lost two babies. In 2011, as she was carrying the third (twin) pregnancy at 17 weeks of amenorrhea, she was admitted to the hospital for an 8-kilogram excess weight gain between two antenatal visits spaced 4 weeks apart. The clinical examination revealed 140 mmHg systolic blood pressure and 80 mm Hg diastolic blood pressure. The following days, the systolic blood pressure ranged between 110 and 120 mm Hg. Furthermore, the presence of bilateral and symmetrical pitting edema of the lower limbs was reported. The laboratory assessment upon admission showed the following results, proteinuria; 3.3 g/24 h, total albumin; 1.7 g/dL, total protein; 5.4 g/dL and total calcium was 75 g/L. The test results for HIV serology, HBs antigen and HCV antibodies as well as antinuclear and native anti-DNA antibodies were negative. The treatment consisted of iron, folic acid and calcium supplementation. Cesarean section was scheduled for the 38th week. The immediate aftermath was simple. Formula feeding was recommended for the newborns and ramipril 1.25 mg was initiated in the mother once daily. The evolution was marked by a progressive reduction in proteinuria around 500 mg/24 h six months after delivery, and below 200 mg/24 h one year later. Pre-eclampsia before 20 weeks of gestation is rare. Hypertension, which is its main clinical sign, may be exceptionally absent at this stage.
Highlights
In general, the term “pre-eclampsia” refers to the presence of hypertension associated with proteinuria occurring after 20 weeks of gestation in a previously non-proteinuric and normotensive woman [1,2]
Sanogo S et al for hemorrhage in placenta previa in 2010. She experienced excess weight gain (5 kg) at the 16th week of amenorrhea which went unnoticed despite regular antenatal follow-up
In 2011, while carrying the third pregnancy at 17 weeks of amenorrhea, she was admitted to the gynecology ward for an 8-kg excess weight gain between 2 antenatal consultations spaced 4 weeks apart
Summary
The term “pre-eclampsia” refers to the presence of hypertension associated with proteinuria occurring after 20 weeks of gestation in a previously non-proteinuric and normotensive woman [1,2]. Sanogo S et al for hemorrhage in placenta previa in 2010 During this pregnancy, she experienced excess weight gain (5 kg) at the 16th week of amenorrhea which went unnoticed despite regular antenatal follow-up. In 2011, while carrying the third pregnancy at 17 weeks of amenorrhea, she was admitted to the gynecology ward for an 8-kg excess weight gain between 2 antenatal consultations spaced 4 weeks apart It was a dichorionic (two placentas) diamniotic (two amniotic sacs) twin pregnancy progressively confirmed by obstetric ultrasound. She received treatment with enoxaparin sodium 4000 IU once daily by subcutaneous injection for one month and switched to lysine acetylsalicylate 100 mg once daily during meals (discontinued 5 days before cesarean section). The evolution was characterized by a progressive reduction in proteinuria around 500 mg/24 h six months after delivery, and below 200 mg/24 h one year later (Table 1)
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