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Preeclampsia/eclampsia 4(PEE4)

MedGen UID:
322874
Concept ID:
C1836255
Disease or Syndrome
Synonym: PEE4
 
Gene (location): STOX1 (10q22.1)
 
Monarch Initiative: MONDO:0012266
OMIM®: 609404

Definition

Severe preeclampsia can also affect the fetus, with impairment of blood and oxygen flow leading to growth problems or stillbirth. Infants delivered early due to preeclampsia may have complications associated with prematurity, such as breathing problems caused by underdeveloped lungs.

Between 10 and 20 percent of women with severe preeclampsia develop another potentially life-threatening complication called HELLP syndrome. HELLP stands for hemolysis (premature red blood cell breakdown), elevated liver enzyme levels, and low platelets (cells involved in blood clotting), which are the key features of this condition.

In many cases, symptoms of preeclampsia go away within a few days after the baby is born. In severe cases, however, preeclampsia can damage the mother's organs, such as the heart, liver, and kidneys, and can lead to life-threatening complications. Extremely high blood pressure in the mother can cause bleeding in the brain (hemorrhagic stroke). The effects of high blood pressure on the brain (hypertensive encephalopathy) may also result in seizures. If seizures occur, the condition is considered to have worsened to eclampsia, which can result in coma. About 1 in 200 women with untreated preeclampsia develop eclampsia. Eclampsia can also develop without any obvious signs of preeclampsia.

Women who have had preeclampsia have approximately twice the lifetime risk of heart disease and stroke than do women in the general population. Researchers suggest that preeclampsia, heart disease, and stroke may share common risk factors. Women who have diseases such as obesity, hypertension, heart disease, diabetes, or kidney disease before they become pregnant have an increased risk of developing preeclampsia. Preeclampsia is most likely to occur in a woman's first pregnancy, although it can occur in subsequent pregnancies, particularly in women with other health conditions.

Many women with mild preeclampsia do not feel ill, and the condition is often first detected through blood pressure and urine testing in their doctor's office. In addition to hypertension and proteinuria, signs and symptoms of preeclampsia can include excessive swelling (edema) of the face or hands and a weight gain of more than 3 to 5 pounds in a week due to fluid retention. Affected women may also experience headaches, dizziness, irritability, shortness of breath, a decrease in urination, upper abdominal pain, and nausea or vomiting. Vision changes may develop, including flashing lights or spots, increased sensitivity to light (photophobia), blurry vision, or temporary blindness.

Preeclampsia is a complication of pregnancy in which affected women develop high blood pressure (hypertension); they can also have abnormally high levels of protein in their urine (proteinuria). This condition usually occurs in the last few months of pregnancy and often requires early delivery of the infant. However, this condition can also appear shortly after giving birth (postpartum preeclampsia). [from MedlinePlus Genetics]

Professional guidelines

PubMed

Scudo M, Petruzziello L, Carbone F, Logoteta A, Paoni Saccone G, D'Oria O, Galoppi P, Brunelli R, Monti M
Minerva Obstet Gynecol 2022 Aug;74(4):348-355. Epub 2021 Apr 20 doi: 10.23736/S2724-606X.21.04733-3. PMID: 33876898
Erez O, Mastrolia SA, Thachil J
Am J Obstet Gynecol 2015 Oct;213(4):452-63. Epub 2015 Mar 31 doi: 10.1016/j.ajog.2015.03.054. PMID: 25840271
Weitzel HK, Lorenz U, Kipper B
J Perinat Med 1987;15(5):441-6. doi: 10.1515/jpme.1987.15.5.441. PMID: 3443899

Curated

UK NICE guideline (NG133), Hypertension in pregnancy: diagnosis and management, 2023

Recent clinical studies

Etiology

Simmons D, Immanuel J, Hague WM, Teede H, Nolan CJ, Peek MJ, Flack JR, McLean M, Wong V, Hibbert E, Kautzky-Willer A, Harreiter J, Backman H, Gianatti E, Sweeting A, Mohan V, Enticott J, Cheung NW; TOBOGM Research Group
N Engl J Med 2023 Jun 8;388(23):2132-2144. Epub 2023 May 5 doi: 10.1056/NEJMoa2214956. PMID: 37144983
Rayes B, Ardissino M, Slob EAW, Patel KHK, Girling J, Ng FS
JAMA Netw Open 2023 Feb 1;6(2):e230034. doi: 10.1001/jamanetworkopen.2023.0034. PMID: 36800181Free PMC Article
Li P, Wang H, Guo L, Gou X, Chen G, Lin D, Fan D, Guo X, Liu Z
BMC Med 2022 Nov 15;20(1):443. doi: 10.1186/s12916-022-02657-x. PMID: 36380372Free PMC Article
Villar J, Ariff S, Gunier RB, Thiruvengadam R, Rauch S, Kholin A, Roggero P, Prefumo F, do Vale MS, Cardona-Perez JA, Maiz N, Cetin I, Savasi V, Deruelle P, Easter SR, Sichitiu J, Soto Conti CP, Ernawati E, Mhatre M, Teji JS, Liu B, Capelli C, Oberto M, Salazar L, Gravett MG, Cavoretto PI, Nachinab VB, Galadanci H, Oros D, Ayede AI, Sentilhes L, Bako B, Savorani M, Cena H, García-May PK, Etuk S, Casale R, Abd-Elsalam S, Ikenoue S, Aminu MB, Vecciarelli C, Duro EA, Usman MA, John-Akinola Y, Nieto R, Ferrazi E, Bhutta ZA, Langer A, Kennedy SH, Papageorghiou AT
JAMA Pediatr 2021 Aug 1;175(8):817-826. doi: 10.1001/jamapediatrics.2021.1050. PMID: 33885740Free PMC Article
Lee SY, Cabral HJ, Aschengrau A, Pearce EN
J Clin Endocrinol Metab 2020 May 1;105(5):e2015-23. doi: 10.1210/clinem/dgz275. PMID: 31838502Free PMC Article

Diagnosis

Simmons D, Immanuel J, Hague WM, Teede H, Nolan CJ, Peek MJ, Flack JR, McLean M, Wong V, Hibbert E, Kautzky-Willer A, Harreiter J, Backman H, Gianatti E, Sweeting A, Mohan V, Enticott J, Cheung NW; TOBOGM Research Group
N Engl J Med 2023 Jun 8;388(23):2132-2144. Epub 2023 May 5 doi: 10.1056/NEJMoa2214956. PMID: 37144983
Mora-Palazuelos C, Bermúdez M, Aguilar-Medina M, Ramos-Payan R, Ayala-Ham A, Romero-Quintana JG
Medicine (Baltimore) 2022 Sep 30;101(39):e30870. doi: 10.1097/MD.0000000000030870. PMID: 36181055Free PMC Article
Villar J, Ariff S, Gunier RB, Thiruvengadam R, Rauch S, Kholin A, Roggero P, Prefumo F, do Vale MS, Cardona-Perez JA, Maiz N, Cetin I, Savasi V, Deruelle P, Easter SR, Sichitiu J, Soto Conti CP, Ernawati E, Mhatre M, Teji JS, Liu B, Capelli C, Oberto M, Salazar L, Gravett MG, Cavoretto PI, Nachinab VB, Galadanci H, Oros D, Ayede AI, Sentilhes L, Bako B, Savorani M, Cena H, García-May PK, Etuk S, Casale R, Abd-Elsalam S, Ikenoue S, Aminu MB, Vecciarelli C, Duro EA, Usman MA, John-Akinola Y, Nieto R, Ferrazi E, Bhutta ZA, Langer A, Kennedy SH, Papageorghiou AT
JAMA Pediatr 2021 Aug 1;175(8):817-826. doi: 10.1001/jamapediatrics.2021.1050. PMID: 33885740Free PMC Article
Cerdeira AS, O'Sullivan J, Ohuma EO, Harrington D, Szafranski P, Black R, Mackillop L, Impey L, Greenwood C, James T, Smith I, Papageorghiou AT, Knight M, Vatish M
Hypertension 2019 Oct;74(4):983-990. Epub 2019 Aug 12 doi: 10.1161/HYPERTENSIONAHA.119.12739. PMID: 31401877Free PMC Article
Wilkerson RG, Ogunbodede AC
Emerg Med Clin North Am 2019 May;37(2):301-316. doi: 10.1016/j.emc.2019.01.008. PMID: 30940374

Therapy

Simmons D, Immanuel J, Hague WM, Teede H, Nolan CJ, Peek MJ, Flack JR, McLean M, Wong V, Hibbert E, Kautzky-Willer A, Harreiter J, Backman H, Gianatti E, Sweeting A, Mohan V, Enticott J, Cheung NW; TOBOGM Research Group
N Engl J Med 2023 Jun 8;388(23):2132-2144. Epub 2023 May 5 doi: 10.1056/NEJMoa2214956. PMID: 37144983
Rayes B, Ardissino M, Slob EAW, Patel KHK, Girling J, Ng FS
JAMA Netw Open 2023 Feb 1;6(2):e230034. doi: 10.1001/jamanetworkopen.2023.0034. PMID: 36800181Free PMC Article
Li P, Wang H, Guo L, Gou X, Chen G, Lin D, Fan D, Guo X, Liu Z
BMC Med 2022 Nov 15;20(1):443. doi: 10.1186/s12916-022-02657-x. PMID: 36380372Free PMC Article
Cerdeira AS, O'Sullivan J, Ohuma EO, Harrington D, Szafranski P, Black R, Mackillop L, Impey L, Greenwood C, James T, Smith I, Papageorghiou AT, Knight M, Vatish M
Hypertension 2019 Oct;74(4):983-990. Epub 2019 Aug 12 doi: 10.1161/HYPERTENSIONAHA.119.12739. PMID: 31401877Free PMC Article
Wilkerson RG, Ogunbodede AC
Emerg Med Clin North Am 2019 May;37(2):301-316. doi: 10.1016/j.emc.2019.01.008. PMID: 30940374

Prognosis

Rayes B, Ardissino M, Slob EAW, Patel KHK, Girling J, Ng FS
JAMA Netw Open 2023 Feb 1;6(2):e230034. doi: 10.1001/jamanetworkopen.2023.0034. PMID: 36800181Free PMC Article
Salazar MR, Espeche WG, Leiva Sisnieguez CE, Juliano PL, Vulcano MV, Sanchez Caro L, Minetto J, Balbín E, Carbajal HA
J Hum Hypertens 2023 Jan;37(1):36-41. Epub 2022 Jan 16 doi: 10.1038/s41371-021-00649-7. PMID: 35034090
Gleason JL, Grewal J, Chen Z, Cernich AN, Grantz KL
JAMA Netw Open 2021 Dec 1;4(12):e2138414. doi: 10.1001/jamanetworkopen.2021.38414. PMID: 34910153Free PMC Article
Villar J, Ariff S, Gunier RB, Thiruvengadam R, Rauch S, Kholin A, Roggero P, Prefumo F, do Vale MS, Cardona-Perez JA, Maiz N, Cetin I, Savasi V, Deruelle P, Easter SR, Sichitiu J, Soto Conti CP, Ernawati E, Mhatre M, Teji JS, Liu B, Capelli C, Oberto M, Salazar L, Gravett MG, Cavoretto PI, Nachinab VB, Galadanci H, Oros D, Ayede AI, Sentilhes L, Bako B, Savorani M, Cena H, García-May PK, Etuk S, Casale R, Abd-Elsalam S, Ikenoue S, Aminu MB, Vecciarelli C, Duro EA, Usman MA, John-Akinola Y, Nieto R, Ferrazi E, Bhutta ZA, Langer A, Kennedy SH, Papageorghiou AT
JAMA Pediatr 2021 Aug 1;175(8):817-826. doi: 10.1001/jamapediatrics.2021.1050. PMID: 33885740Free PMC Article
Cerdeira AS, O'Sullivan J, Ohuma EO, Harrington D, Szafranski P, Black R, Mackillop L, Impey L, Greenwood C, James T, Smith I, Papageorghiou AT, Knight M, Vatish M
Hypertension 2019 Oct;74(4):983-990. Epub 2019 Aug 12 doi: 10.1161/HYPERTENSIONAHA.119.12739. PMID: 31401877Free PMC Article

Clinical prediction guides

Simmons D, Immanuel J, Hague WM, Teede H, Nolan CJ, Peek MJ, Flack JR, McLean M, Wong V, Hibbert E, Kautzky-Willer A, Harreiter J, Backman H, Gianatti E, Sweeting A, Mohan V, Enticott J, Cheung NW; TOBOGM Research Group
N Engl J Med 2023 Jun 8;388(23):2132-2144. Epub 2023 May 5 doi: 10.1056/NEJMoa2214956. PMID: 37144983
Rayes B, Ardissino M, Slob EAW, Patel KHK, Girling J, Ng FS
JAMA Netw Open 2023 Feb 1;6(2):e230034. doi: 10.1001/jamanetworkopen.2023.0034. PMID: 36800181Free PMC Article
Li P, Wang H, Guo L, Gou X, Chen G, Lin D, Fan D, Guo X, Liu Z
BMC Med 2022 Nov 15;20(1):443. doi: 10.1186/s12916-022-02657-x. PMID: 36380372Free PMC Article
Bandeira DB, Olivatti TOF, Bolfi F, Boguszewski CL, Dos Santos Nunes-Nogueira V
Pituitary 2022 Jun;25(3):352-362. Epub 2022 Jan 30 doi: 10.1007/s11102-022-01208-0. PMID: 35098440
Cerdeira AS, O'Sullivan J, Ohuma EO, Harrington D, Szafranski P, Black R, Mackillop L, Impey L, Greenwood C, James T, Smith I, Papageorghiou AT, Knight M, Vatish M
Hypertension 2019 Oct;74(4):983-990. Epub 2019 Aug 12 doi: 10.1161/HYPERTENSIONAHA.119.12739. PMID: 31401877Free PMC Article

Recent systematic reviews

Yang Y, Huang XX, Huo RX, Lin JY
Arch Gynecol Obstet 2024 Apr;309(4):1135-1149. Epub 2023 Nov 3 doi: 10.1007/s00404-023-07259-3. PMID: 37921880
Schliep KC, Mclean H, Yan B, Qeadan F, Theilen LH, de Havenon A, Majersik JJ, Østbye T, Sharma S, Varner MW
Hypertension 2023 Feb;80(2):257-267. Epub 2022 Nov 8 doi: 10.1161/HYPERTENSIONAHA.122.19399. PMID: 36345823Free PMC Article
Bandeira DB, Olivatti TOF, Bolfi F, Boguszewski CL, Dos Santos Nunes-Nogueira V
Pituitary 2022 Jun;25(3):352-362. Epub 2022 Jan 30 doi: 10.1007/s11102-022-01208-0. PMID: 35098440
Li F, Qin J, Zhang S, Chen L
Pregnancy Hypertens 2021 Jun;24:13-21. Epub 2021 Feb 14 doi: 10.1016/j.preghy.2021.02.001. PMID: 33626437
Berhe AK, Kassa GM, Fekadu GA, Muche AA
BMC Pregnancy Childbirth 2018 Jan 18;18(1):34. doi: 10.1186/s12884-018-1667-7. PMID: 29347927Free PMC Article

Supplemental Content

Table of contents

    Clinical resources

    Practice guidelines

    • PubMed
      See practice and clinical guidelines in PubMed. The search results may include broader topics and may not capture all published guidelines. See the FAQ for details.

    Curated

    • NICE, 2023
      UK NICE guideline (NG133), Hypertension in pregnancy: diagnosis and management, 2023

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