Pulmonary edema in the context of "Preeclampsia"

Hyperpnea, or hyperpnoea (forced respiration), is increased volume of air taken during breathing. It can occur with or without an increase in respiration rate. It is characterized by deep breathing. It may be physiologic—as when required by oxygen to meet metabolic demand of body tissues (for example, during or after heavy exercise, or when the body lacks oxygen at high altitude or as a result of anemia, or any other condition requiring more respiration)—or it may be pathologic, as when sepsis is severe or during pulmonary edema. Hyperpnea is further characterized by the required use of muscle contraction during both inspiration and expiration. Thus, hyperpnea is intense active breathing as opposed to the passive process of normal expiration.

Hyperpnea is distinguished from tachypnea, which is a respiratory rate greater than normal, resulting in rapid and shallow breaths, but not necessarily increasing volume in breathing. Hyperpnea is also distinguished from hyperventilation, which is over-ventilation (an increase in minute ventilation), which involves an increase in volume and respiration rate, resulting in rapid and deep breaths.

Pre-eclampsia is a multi-system disorder specific to pregnancy, characterized by the new onset of high blood pressure and often a significant amount of protein in the urine (proteinuria) or by the new onset of high blood pressure along with significant end-organ damage, with or without the proteinuria. When it arises, the condition begins after 20 weeks of pregnancy. In severe cases of the disease there may be red blood cell breakdown, a low blood platelet count, impaired liver function, kidney dysfunction, swelling, shortness of breath due to fluid in the lungs, or visual disturbances. Pre-eclampsia increases the risk of undesirable as well as lethal outcomes for both the mother and the fetus including preterm labor. If left untreated, it may result in seizures at which point it is known as eclampsia.

Risk factors for pre-eclampsia include obesity, prior hypertension, older age, and diabetes mellitus. It is also more frequent in a woman's first pregnancy and if she is carrying twins. The underlying mechanisms are complex and involve abnormal formation of blood vessels in the placenta amongst other factors. Most cases are diagnosed before delivery, and may be categorized depending on the gestational week at delivery. Commonly, pre-eclampsia continues into the period after delivery, then known as postpartum pre-eclampsia. Rarely, pre-eclampsia may begin in the period after delivery. While historically both high blood pressure and protein in the urine were required to make the diagnosis, some definitions also include those with hypertension and any associated organ dysfunction. Blood pressure is defined as high when it is greater than 140 mmHg systolic or 90 mmHg diastolic at two separate times, more than four hours apart in a woman after twenty weeks of pregnancy. Pre-eclampsia is routinely screened during prenatal care.