Important Differential Diagnosis of Preeclampsia in USMLE Questions

It is important to Differential Diagnosis between Preeclampsia and SLE (systemic lupus sclerosis) in pregnancy because management is totally different.

SLE shows itself by:
- Hypertension in a pregnant woman in the setting of
o Massive proteinuria
o Malar rash
o Positive ANA titer
- Also pay attention to thse facts:I
- In SLE is especially at the point of hypertension, we would have Glomerulonephritis.
- SLE very rarely starts in pregnancy, so look for the history. (They sometimes provide you with history of positive signs and symptoms not the actual disease)

Treatment of SLE in pregnancy: Do not be aggressive, you can control it and save the baby.

Signs and Symptoms of Magnesium Sulfate toxicity

In order:
- Depressed DTR (deep tendon reflex) is the first sign for Magnesium Sulfate toxicity which requires stopping it and administration of Calcium Gluconate.
- Respiratory depression
- Coma
- Cardiac arrest
- Death.

Eclampsia

Presentation: It is very easy to diagnose, as it shows itself by a generalized Tonic-Clonic seizure that manifest like grand mal, in a pregnant patient.
I know there are some other signs and symptoms, but knowing these two, you can both make the diagnosis of eclampsia and determine the management method, so do not waste time!

It occurs 25% Before Labor, 50% During Labor 25% After Delivery.
Attention: In post delivery seizure, rule out eclampsia, as well as other causes (drugs effect, …)

Attention: Most common etiology of death in Eclampsia is Hemorrhagic stroke due to Hypertension and thrombocytopenia.