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Unusual clinical course of preeclampsia heralded by generalized edema
Author(s) -
Kojima Takashi,
Yamada Takahiro,
Yamada Takashi,
Morikawa Mamoru,
Cho Kazutoshi,
Minakami Hisanori
Publication year - 2013
Publication title -
journal of obstetrics and gynaecology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 1341-8076
DOI - 10.1111/jog.12080
Subject(s) - medicine , proteinuria , preeclampsia , oligohydramnios , pregnancy , betamethasone , edema , weight gain , obstetrics , birth weight , anesthesia , gestation , gastroenterology , body weight , kidney , biology , genetics
Preeclampsia monitored by the amount of proteinuria usually does not show amelioration during pregnancy. A 37‐year‐old nulliparous woman was admitted to our hospital at gestational week ( GW ) 24 −1/7 due to rapid weight gain (6.2 kg/4 weeks) and oligohydramnios. Hypertension (151/91 mmHg) appeared at GW 25 −0/7 and proteinuria not detected at GW 24 −0/7 became significant (0.55 g/day) at GW 25 −2/7 . During the 2 successive weeks after administration of betamethasone at 12 mg twice and transabdominal amnioinfusion with 250 mL of Ringer's acetate solution at GW 25 −3/7 , generalized edema, proteinuria and thrombocytopenia markedly improved: bodyweight, 78.0 to 69.0 kg; proteinuria, from 7.1 to 1.3 g/day; and platelet count, from 111 to 230 × 10 9 /L. However, intrauterine infection accompanied by non‐reassuring fetal status necessitated emergency cesarean section at GW 28 −3/7 . Extraordinary bodyweight gain can herald the occurrence of preeclampsia and this weight gain together with signs of preeclampsia can ameliorate even during pregnancy, although its mechanism is unclear.