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Preeklampsi och eklampsi

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Sakkunnig:
Definition:
En multiorgansjukdom med graviditetshypertoni och nydebuterat engagemang av ett eller flera organsystem och/eller fostret efter graviditetsvecka 20 med antingen proteinuri eller annan njur-, lever-, neurologisk- koagulations- eller cirkulationspåverkan. Tidigare omfattade definitionen endast graviditetshyperoni och proteinuri. 
Förekomst:
Runt 3–7 % per år av samtliga gravida kvinnor i Sverige drabbas.
Symtom:
De vanligaste symtomen vid allvarlig preeklampsi är huvudvärk, ögonsymtom, illamående eller magsmärtor. 
Kliniska fynd:
Blodtryck ≥140/90 mmHg vid två separata mätningar (4 timmar mellan) och samtidigt förekomst av proteinuri eller ovan beskrivna organpåverkan. Ibland ses stor viktökning, låga symfys-fundus mått, ödem.
Diagnostik:
Det finns inga pålitliga screeningtest. Blodtryck och proteinuri undersöks rutinmässigt under graviditeten.
Behandling:
Förlossning är det enda som gör att preeklampsi/eklampsi-tillståndet går över. Ibland anledning till för tidigt inducerad förlossning. Antihypertensiv behandling vid blodtryck ≥140/100 mmHg.
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  • Maria M. Sennström, överläkare, PO Graviditet och förlossning, Karolinska universitetssjukhuset Solna
  • Athena Adeli, legitimerad läkare, Karolinska Institutet