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Svangerskapsforgiftning (preeklampsi): Diagnostikk

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Lege eller jordmor bør ved første svangerskapskontroll avklare om det foreligger risikofaktorer for svangerskapsforgiftning. Har du risikofaktorer som tilsier høy risiko for svangerskapsforgiftning, blir du gjerne henvist til vurdering hos sykehusspesialist.

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Mange vil være uten symptomer på det tidspunkt diagnosen stilles, mens andre kan ha tegn på alvorlig svangerskapsforgiftning. Dersom legen ved svangerskapsuke 20 eller senere påviser for høyt blodtrykk og proteiner i urinen (som tegn på sviktende nyrefunksjon) eller tegn til sviktende funksjon i andre organer, har du svangerskapsforgiftning. Unormale funn i blodprøver som lav blodprosent, lave blodplater, høye leverprøver og høy nyreprøve kan også bidra til at diagnosen stilles. 

Blodtrykksmåling skal gjøres ved alle svangerskapskontroller. Dersom overtrykket (systolisk blodtrykk) er over eller lik 140 mmHg og/eller undertrykket er over eller lik 90 mmHg - i to separate målinger - er det forhøyet og skal følges opp.

Hos sykehusspesialist vil det være aktuelt å undersøke fosterets hjerteaktivitet og livmorens sammentrekninger ved CTG (kardiotokogram) og en ultralydundersøkelse for å vurdere fosterets vekst og eventuelt blodstrømsmålinger.

Blodbaserte markører for svangerskapsforgiftning (sFlt-1 og PlGF) er tatt i bruk ved noen norske sykehus. Disse er vist å kunne være til hjelp for å stille diagnosen tidligere. Det gjøres forskning for å vurdere om dette er markører som skal innføres som del av rutinemessig screening for svangerskapsforgiftning.

Vil du vite mer

Dette dokumentet er basert på det profesjonelle dokumentet Preeklampsi og hypertensive svangerskapskomplikasjoner . Referanselisten for dette dokumentet vises nedenfor

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