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Preeclampsia/eclampsia 5(PEE5)

MedGen UID:
482918
Concept ID:
C3281288
Disease or Syndrome
Synonym: PEE5
 
Gene (location): CORIN (4p12)
 
Monarch Initiative: MONDO:0013817
OMIM®: 614595

Definition

Preeclampsia, which along with chronic hypertension and gestational hypertension comprise the hypertensive disorders of pregnancy, is characterized by new hypertension (blood pressure 140/90 or greater) presenting after 20 weeks' gestation with clinically relevant proteinuria. Preeclampsia is 1 of the top 4 causes of maternal mortality and morbidity worldwide (summary by Payne et al., 2011). For a general phenotypic description and a discussion of genetic heterogeneity of preeclampsia/eclampsia, see PEE1 (189800). [from OMIM]

Additional description

From MedlinePlus Genetics
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).

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.

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.

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.

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.  https://medlineplus.gov/genetics/condition/preeclampsia

Professional guidelines

PubMed

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
Yancey LM, Withers E, Bakes K, Abbott J
J Emerg Med 2011 Apr;40(4):380-4. Epub 2008 Sep 23 doi: 10.1016/j.jemermed.2008.02.056. PMID: 18814997
Sibai BM, Stella CL
Am J Obstet Gynecol 2009 May;200(5):481.e1-7. Epub 2008 Nov 18 doi: 10.1016/j.ajog.2008.07.048. PMID: 19019323

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
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
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
Bushnell C, McCullough LD, Awad IA, Chireau MV, Fedder WN, Furie KL, Howard VJ, Lichtman JH, Lisabeth LD, Piña IL, Reeves MJ, Rexrode KM, Saposnik G, Singh V, Towfighi A, Vaccarino V, Walters MR; American Heart Association Stroke Council; Council on Cardiovascular and Stroke Nursing; Council on Clinical Cardiology; Council on Epidemiology and Prevention; Council for High Blood Pressure Research
Stroke 2014 May;45(5):1545-88. Epub 2014 Feb 6 doi: 10.1161/01.str.0000442009.06663.48. PMID: 24503673Free 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
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
Skliut M, Jamieson DG
Curr Pain Headache Rep 2016 Oct;20(10):56. doi: 10.1007/s11916-016-0585-5. PMID: 27562782
Sibai BM, Stella CL
Am J Obstet Gynecol 2009 May;200(5):481.e1-7. Epub 2008 Nov 18 doi: 10.1016/j.ajog.2008.07.048. PMID: 19019323

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
Meazaw MW, Chojenta C, Muluneh MD, Loxton D
PLoS One 2020;15(8):e0237600. Epub 2020 Aug 19 doi: 10.1371/journal.pone.0237600. PMID: 32813750Free 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
Mugo M, Govindarajan G, Kurukulasuriya LR, Sowers JR, McFarlane SI
Curr Hypertens Rep 2005 Oct;7(5):348-54. doi: 10.1007/s11906-005-0068-2. PMID: 16157076
Sibai BM
Am J Obstet Gynecol 1990 May;162(5):1141-5. doi: 10.1016/0002-9378(90)90002-o. PMID: 2288560

Prognosis

Joseph KS, Lisonkova S, Boutin A, Muraca GM, Razaz N, John S, Sabr Y, Chan WS, Mehrabadi A, Brandt JS, Schisterman EF, Ananth CV
Am J Obstet Gynecol 2024 Apr;230(4):440.e1-440.e13. Epub 2024 Mar 12 doi: 10.1016/j.ajog.2023.12.038. PMID: 38480029
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
Meazaw MW, Chojenta C, Muluneh MD, Loxton D
PLoS One 2020;15(8):e0237600. Epub 2020 Aug 19 doi: 10.1371/journal.pone.0237600. PMID: 32813750Free 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
Turner K, Hameed AB
Curr Hypertens Rev 2017;13(2):80-88. doi: 10.2174/1573402113666170529110024. PMID: 28554307

Clinical prediction guides

Pooh RK
J Obstet Gynaecol Res 2024 May;50(5):793-799. Epub 2024 Feb 17 doi: 10.1111/jog.15908. PMID: 38366809
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
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
Turner K, Hameed AB
Curr Hypertens Rev 2017;13(2):80-88. doi: 10.2174/1573402113666170529110024. PMID: 28554307
Bushnell C, McCullough LD, Awad IA, Chireau MV, Fedder WN, Furie KL, Howard VJ, Lichtman JH, Lisabeth LD, Piña IL, Reeves MJ, Rexrode KM, Saposnik G, Singh V, Towfighi A, Vaccarino V, Walters MR; American Heart Association Stroke Council; Council on Cardiovascular and Stroke Nursing; Council on Clinical Cardiology; Council on Epidemiology and Prevention; Council for High Blood Pressure Research
Stroke 2014 May;45(5):1545-88. Epub 2014 Feb 6 doi: 10.1161/01.str.0000442009.06663.48. PMID: 24503673Free PMC Article

Recent systematic reviews

Hoodbhoy Z, Mohammed N, Nathani KR, Sattar S, Chowdhury D, Maskatia S, Tierney S, Hasan B, Das JK
Am J Perinatol 2023 Mar;40(4):363-374. Epub 2021 May 3 doi: 10.1055/s-0041-1728823. PMID: 33940650
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
Dubey S, Rani J
Taiwan J Obstet Gynecol 2020 Sep;59(5):643-651. doi: 10.1016/j.tjog.2020.07.003. PMID: 32917311
Meazaw MW, Chojenta C, Muluneh MD, Loxton D
PLoS One 2020;15(8):e0237600. Epub 2020 Aug 19 doi: 10.1371/journal.pone.0237600. PMID: 32813750Free PMC Article
McDonald SD, Malinowski A, Zhou Q, Yusuf S, Devereaux PJ
Am Heart J 2008 Nov;156(5):918-30. Epub 2008 Oct 2 doi: 10.1016/j.ahj.2008.06.042. PMID: 19061708

Supplemental Content

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    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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