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Eclampsia

Shí Wikipedia, njikotá édémédé nke onyobulạ
Eclampsia
Dissection of uterus at term eclampsia.
Eclampsia bu onset of seizures(convulsions) nke na eme nwaanyi nwere pre-eclampsia. Pre-eclampsia bu obara mgbali elu nke afo ime nke n'egosi n'uzo ato nke gunyere onset of high blood pressure, mgbe protein kariri na mamiri maobu organ dysfunction na edema. O buru na agwo ya ofuma onwere Ike ibite cardiovascular disease na nsogbu ndi ozo nke ogologo oge, n'oge ufodu ona ebute onwu nke nne na nwa.[1].[2][3][4][5].[6]

Ụkpụrụ nchọpụta maka pre-eclampsia bụ ọbara mgbali elu, nke na-eme mgbe izu 20 nke ime ma ọ bụ n'oge ọkara nke abụọ nke ime.[1] Ọ na-emekarị n'oge atọ nke afọ ime ma nwee ike ime tupu, n'oge, ma ọ bụ mgbe amuchara.[1] Ọrịa ndị ahụ bụ ụdị tonic-clonic ma na-adịkarị ihe dịka otu nkeji.[1] Mgbe nkụchi ahụ gasịrị, enwere oge mgbagwoju anya ma ọ bụ coma.[1] Nsogbu ndị ọzọ gụnyere oyi ịba n'ahụ, Ọbara ọgbụgba n'ụbụrụ, nsogbu akụrụ, ọzịza akpa ume, Ọrịa HELLP, coagulopathy, abruption placental na nkwụsị obi.[1][1]

A na-atụ aro obere aspirin iji gbochie pre-eclampsia na eclampsia n'ime ndị nọ n'ihe ize ndụ dị elu.[7] Ntuziaka mgbochi ndị ọzọ gụnyere Mgbakwunye calcium n'ebe ndị calcium dị ala na ọgwụgwọ nke ọbara mgbali elu na ọgwụ mgbochi ọbara mgbali.[8][9] Mmega ahụ n'oge ime nwekwara ike ịba uru.[1] Ojiji nke intravenous ma ọ bụ intramuscular magnesium sulfate na-eme ka nsonaazụ dị mma na ndị nwere nnukwu pre-eclampsia na eclampsia ma bụrụ n'ozuzu ya na-adịghị ize ndụ. [10][11] Nhọrọ ọgwụgwọ gụnyere ọgwụ mgbochi ọbara dịka hydralazine na inye nwa ahụ n'ọnọdụ mberede ma ọ bụ site na akụkụ ahụ nwanyị ma ọ bụ nke a na-aṅụ ara.[4][1]

A na-eme atụmatụ na Pre-eclampsia na-emetụta ihe dị ka 5% nke ọmụmụ n'ụwa niile ebe eclampsia nwere mmetụta nke ihe dị ka 1.4% nke ọmụmụ.[12] N'ime mba ndị mepere emepe, ọnụ ọgụgụ eclampsia bụ ihe dịka 1 n'ime ụmụ 2,000 n'ihi nlekọta ahụike ka mma ebe na mba ndị na-emepe emepe ọ nwere ike imetụta okpukpu 10-30 karịa ọtụtụ ụmụ nwanyị.[1][13] Nsogbu ọbara mgbali elu nke ime ime bụ otu n'ime ihe ndị a na-ahụkarị na-akpata ọnwụ n'ime ime.[3] Ha kpatara ọnwụ 46,900 na 2015. [14] Ọnwụ nne n'ihi eclampsia na-eme na ọnụọgụ nke ihe dịka 0-1.8% nke ndị na-arịa ya na mba ndị na-enweta ego dị elu na ihe ruru 15% nke ndị na ya na mba na-enweta obere ego.[15] Okwu eclampsia sitere na okwu Grik maka àmụ̀mà.[16] Nkọwa mbụ a maara banyere ọnọdụ ahụ bụ nke Hippocrates na narị afọ nke ise BC. [6][16]

Ihe ịrịba ama na mgbaàmà

[dezie | dezie ebe o si]

Eclampsia bụ nsogbu nke ime ime nke a na-ahụ site na nkụchi na ọnọdụ nke pre-eclampsia.[17] Ọtụtụ ụmụ nwanyị nwere ihe ịrịba ama / mgbaàmà na-egosi na awa ole na ole tupu nkụchi mbụ. Dị ka ọ na-adịkarị, nwanyị ahụ na-enwe ọbara mgbali elu tupu mmalite nke convulsion (nkwụsị). [18] Ihe ịrịba ama na mgbaàmà ndị ọzọ ị ga-ele anya gụnyere: [19]

  • Isi ọwụwa na-adịgide adịgide (na-adịgide) n'ihu ma ọ bụ occipital ma ọ bụ isi ọwụwa égbè eluigwe) [20]
  • Nsogbu anya (ọhụhụ na-adịghị mma, photophobia, diplopopia)
  • Photophobia (ya bụ, ìhè na-egbuke egbuke na-akpata ahụ erughị ala)
  • Ihe mgbu nke afọ
    • Ma ọ bụ na mpaghara epigastric (etiti afọ n'elu navel, ma ọ bụ eriri afọ)
    • Na / ma ọ bụ n'elu akụkụ aka nri nke afọ (n'okpuru akụkụ aka nri ya nke eriri afọ)
  • Mgbanwe nke ọnọdụ uche (mgbagwoju anya)

Ihe mgbaàmà ọ bụla n'ime ihe mgbaàmà ndị a nwere ike ịdị tupu ma ọ bụ mgbe ọ nwesịrị nkụchi.[21] O nwekwara ike ịbụ na nwanyị ahụ enweghị mgbaàmà tupu mmalite nke nkụchi.

Ihe ịrịba ama ụbụrụ ndị ọzọ nwere ike ibute nkụchi ahụ gụnyere agbọ onunu, ịgbọ agbọ, isi ọwụwa, na ìsì. Ọ bụrụ na nsogbu nke ọdịda ọtụtụ akụkụ ahụ na-esote, ihe ịrịba ama na mgbaàmà nke akụkụ ahụ na - dara ada ga-apụta, dị ka ihe mgbu afọ, yellowness, iku ume dị mkpụmkpụ, na mbelata nsị.

Ihe ndị e ji mara ya

[dezie | dezie ebe o si]

Eclamptic seizure ka akpowara dika tonic-clonic seizure nke nwere Ike ebute Anya aju. Ona ebute kwa shriek maobu ite mkpu na muscle nke aka, ukwu, azu na obi is Ike. Mgbe oge tonic, nwanyi ahu nwere Ike Ina ahu cyanotic.[22].[23].[24]

Nsogbu

[dezie | dezie ebe o si]

Enwere ihe ize ndụ nye nne na nwa e bu n'afọ mgbe eclampsia na-eme. Nwa e bu n'afọ nwere ike itolite nke ọma karịa ka ọ dị n'ime akpa nwa (akpa nwa) nke nwanyị nwere eclampsia, nke a na-akpọ Mgbochi uto intrauterine ma nwee ike ime ka nwatakịrị ahụ yie obere maka afọ ime ma ọ bụ amụọ ya na ịdị arọ dị ala.[25] Eclampsia nwekwara ike ịkpata nsogbu na Placenta. Placenta nwere ike ịba ọbara (ọbara ọgbụgba) ma ọ bụ malite ikewapụ n'oge site na mgbidi nke akpa nwa.[26] Ọ bụ ihe dị mma maka placenta ịpụ na mgbidi akpa nwa n'oge ịmụ nwa, mana ọ bụ ihe na-adịghị mma maka ya ịpụ nwa tupu ịmụ nwa; a na-akpọ ọnọdụ a abruption placental ma nwee ike ịdị ize ndụ maka nwa e bu n'afọ.[27] Enweghị ike nke placenta nwekwara ike ime, ọnọdụ nke placenta na-enweghị ike ịkwado mmepe nwa e bu n'afọ kwesịrị ekwesị n'ihi na ọ pụghị inye nwa e bu pụta ìhè oxygen ma ọ bụ ihe oriri.[2] N'oge eclamptic seizure, ịkụ obi nwa ọhụrụ nwere ike ịdị nwayọ karịa ka ọ dị (bradycardia). [1] [28] Ọ bụrụ na nke ọ bụla n'ime nsogbu ndị a emee, nsogbu nwa ọhụrụ nwere ike ịmalite. Ọgwụgwọ nke nkụchi nne nwekwara ike ijikwa bradycardia nwa ọhụrụ. [29] Ọ bụrụ na ihe ize ndụ maka ahụike nke nwa e bu n'afọ ma ọ bụ nne dị elu, ọgwụgwọ doro anya maka eclampsia bụ ịmụ nwa. Ịmụ nwa site na ngalaba ịwa ahụ nwere ike ịdị mkpa, ọkachasị ma ọ bụrụ na ihe atụ nke bradycardia nwa ọhụrụ anaghị edozi mgbe nkeji 10 ruo 15 nke ntinye aka resuscitative gasịrị. [5][30] O nwere ike ịbụ ihe nchebe ịpụta nwa tupu oge eruo karịa ichere izu 40 zuru ezu nke mmepe nwa ọhụrụ iji gwụchaa, n'ihi ya, ịmụ nwa tupu oge bụkwa ihe mgbagwoju anya nke eclampsia. [2][31]

N'ime nne, mgbanwe n'ọhụụ nwere ike ime n'ihi eclampsia, mgbanwe ndị a nwere ike ịgụnye ọhụụ na-adịghị mma, ìsì otu akụkụ (ma ọ bụ nwa oge n'ihi amaurosis fugax ma ọ bụ nke nwere ike ịdịgide adịgide n'ihi retinal detachment), ma ọ bụ ìsì cortical, nke na-emetụta ọhụụ site na anya abụọ.[32][33] Enwekwara nsogbu ndị nwere ike ịdị na akpa ume. Nwanyị ahụ nwere ike ịnwe mmiri na-eji nwayọọ nwayọọ na-anakọta n'ime akpa ume n'usoro a maara dị ka ọzịza akpa ume.[26] N'oge eclamptic seizure, ọ ga-ekwe omume ka mmadụ gbasaa ihe dị n'ime afọ ma na-ekuru ụfọdụ n'ime ihe ndị a n'usoro a maara dị ka aspiration.[25] Ọ bụrụ na ọchịchọ ahụ emee, nwanyị ahụ nwere ike inwe nsogbu iku ume ozugbo ma ọ bụ nwee ike ibute ọrịa n'ime akpa ume mgbe e mesịrị, nke a na-akpọ aspiration pneumonia. [21][34] O nwekwara ike ịbụ na n'oge nkụchi iku ume ga-akwụsị nwa oge ma ọ bụ ghara ịrụ ọrụ nke ọma, a ga-ebelata oke oxygen na-eru n'ahụ na ụbụrụ nwanyị (n'ọnọdụ a maara dị ka hypoxia). [5][35] Ọ bụrụ na ọ na-esiri nwanyị ahụ ike iku ume, ọ nwere ike ịchọ ka iku ume ya kwado nwa oge site na ngwaọrụ enyemaka na usoro a na-akpọ ventilation igwe. N'ọnọdụ ụfọdụ siri ike nke eclampsia, nne nwere ike ịda mbà ma bụrụ onye umengwụ (ụra) ma ọ bụ ọbụna onye nọ n'ọnọdụ coma.[2] Ndị a nwere ike ịbụ ihe ịrịba ama na ụbụrụ na-ebu ibu (cerebral edema) ma ọ bụ ọbara ọgbụgba (intracerebral hemorrhage). [2][3][33]

Ihe ize ndụ

[dezie | dezie ebe o si]

Eclampsia, dị ka pre-eclampsia، na-emekarị na ime mbụ karịa ime ndị ọzọ. [36] [37][38] Ụmụ nwanyị ndị nwere ọbara mgbali elu ogologo oge tupu ha atụọ ime nwere ihe ize ndụ ka ukwuu nke pre-eclampsia.[1][2] Ndị ọrịa nwere ọbara mgbali elu na pre-eclampsia nwere ohere dị ukwuu nke eclampsia.[39] Ọzọkwa, ụmụ nwanyị nwere ọrịa vascular ndị ọzọ dịbu adị (Ọrịa shuga ma ọ bụ nephropathy) ma ọ bụ ọrịa thrombophilia dị ka ọrịa antiphospholipid nọ n'ihe ize ndụ dị elu iji mepụta pre-eclampsia na eclampsia.[1][2] Inwe placenta nke na-eto site na ọtụtụ ime ma ọ bụ hydatidiform mole na-emekwa ka ihe ize ndụ nke eclampsia dịkwuo ukwuu. [1] [2][40] Na mgbakwunye, enwere akụkụ mkpụrụ ndụ ihe nketa: nwanyị nne ya ma ọ bụ nwanne ya nwanyị nwere ọnọdụ ahụ nọ n'ihe ize ndụ dị elu karịa ndị ọzọ.[41] Ndị ọrịa nwere eclampsia nọ n'ihe ize ndụ dị ukwuu maka pre-eclampsia / eclampsía n'oge ime.[2] Ọbịbịa nke pre-eclampsia bụ 5% na ndị ọcha, 9% na ndị Hispanic, na 11% na ndị ọrịa Africa America na nke a nwere ike igosipụta ihe ize ndụ dị oke egwu nke ịmalite pre-eclempsia n'etiti agbụrụ.[42] Tụkwasị na nke a, e gosipụtara na ndị ọrịa ojii nwere ihe ize ndụ dị elu nke ịnwụ site na eclampsia.[7][42]

  1. ↑ 1.0 1.1 1.2 1.3 1.4 1.5 (2014) "Chapter 40: Hypertensive Disorders", Williams Obstetrics, 24th, McGraw-Hill Professional. ISBN 9780071798938.  Kpọpụta njehie: Invalid <ref> tag; name "W2014" defined multiple times with different content
  2. ↑ Lambert (2014). "Preeclampsia: an update.". Acta Anaesthesiologica Belgica 65 (4): 137–49. PMID 25622379. 
  3. ↑ Brown (July 2018). "Hypertensive Disorders of Pregnancy: ISSHP Classification, Diagnosis, and Management Recommendations for International Practice" (in en). Hypertension 72 (1): 24–43. DOI:10.1161/HYPERTENSIONAHA.117.10803. ISSN 0194-911X. PMID 29899139. 
  4. ↑ American College of Obstetricians Gynecologists (November 2013). "Hypertension in pregnancy. Report of the American College of Obstetricians and Gynecologists' Task Force on Hypertension in Pregnancy.". Obstet. Gynecol. 122 (5): 1122–31. DOI:10.1097/01.AOG.0000437382.03963.88. PMID 24150027. Retrieved on 2015-02-22. 
  5. ↑ Bokslag (2016-11-01). "Preeclampsia; short and long-term consequences for mother and neonate" (in en). Early Human Development 102: 47–50. DOI:10.1016/j.earlhumdev.2016.09.007. ISSN 0378-3782. PMID 27659865. 
  6. ↑ Chappell (2021-07-24). "Pre-eclampsia". Lancet 398 (10297): 341–354. DOI:10.1016/S0140-6736(20)32335-7. ISSN 1474-547X. PMID 34051884. 
  7. ↑ Low-Dose Aspirin Use During Pregnancy (en). www.acog.org. Retrieved on 2023-01-27.
  8. ↑ (2011) WHO recommendations for prevention and treatment of pre-eclampsia and eclampsia.. ISBN 978-92-4-154833-5. 
  9. ↑ Henderson (20 May 2014). "Low-dose aspirin for prevention of morbidity and mortality from preeclampsia: a systematic evidence review for the U.S. Preventive Services Task Force.". Annals of Internal Medicine 160 (10): 695–703. DOI:10.7326/M13-2844. PMID 24711050. 
  10. ↑ Smith (5 February 2013). "An integrative review of the side effects related to the use of magnesium sulfate for pre-eclampsia and eclampsia management.". BMC Pregnancy and Childbirth 13: 34. DOI:10.1186/1471-2393-13-34. PMID 23383864. 
  11. ↑ McDonald (August 2012). "A systematic review of maternal and infant outcomes following magnesium sulfate for pre-eclampsia/eclampsia in real-world use.". International Journal of Gynaecology and Obstetrics 118 (2): 90–6. DOI:10.1016/j.ijgo.2012.01.028. PMID 22703834. 
  12. ↑ Abalos (September 2013). "Global and regional estimates of preeclampsia and eclampsia: a systematic review.". European Journal of Obstetrics, Gynecology, and Reproductive Biology 170 (1): 1–7. DOI:10.1016/j.ejogrb.2013.05.005. PMID 23746796. 
  13. ↑ Kpọpụta njehie: Invalid <ref> tag; no text was provided for refs named Aru2013
  14. ↑ GBD 2015 Mortality and Causes of Death (8 October 2016). "Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980-2015: a systematic analysis for the Global Burden of Disease Study 2015.". Lancet 388 (10053): 1459–1544. DOI:10.1016/s0140-6736(16)31012-1. PMID 27733281. 
  15. ↑ Ghulmiyyah (2012-02-01). "Maternal Mortality From Preeclampsia/Eclampsia" (in en). Seminars in Perinatology 36 (1): 56–59. DOI:10.1053/j.semperi.2011.09.011. ISSN 0146-0005. PMID 22280867. 
  16. ↑ 16.0 16.1 Emile R. Mohler (2006). Advanced Therapy in Hypertension and Vascular Disease. PMPH-USA, 407–408. ISBN 9781550093186. 
  17. ↑ Stone (2017). "Chapter 19: Seizures", Current diagnosis & treatment. Emergency medicine, 8th, New York: McGraw-Hill. ISBN 9780071840613. OCLC 959876721. 
  18. ↑ (2013) "Contemporary Clinical Management of the Cerebral Complications of Preeclampsia". Obstetrics and Gynecology International 2013: 1–10. DOI:10.1155/2013/985606. PMID 24489551. 
  19. ↑ Berhan (June 2015). "Should magnesium sulfate be administered to women with mild pre-eclampsia? A systematic review of published reports on eclampsia: Systematic review of reports on eclampsia" (in en). Journal of Obstetrics and Gynaecology Research 41 (6): 831–842. DOI:10.1111/jog.12697. PMID 25833188. 
  20. ↑ Zeeman (June 2009). "Neurologic Complications of Pre-eclampsia". Seminars in Perinatology 33 (3): 166–172. DOI:10.1053/j.semperi.2009.02.003. ISSN 0146-0005. PMID 19464507. 
  21. ↑ 21.0 21.1 Gabbe MD (2017). "Chapter 31: Preeclampsia and Hypertensive Disorders", Obstetrics : Normal and Problem Pregnancies, Jennifer R. Niebyl MD, Joe Leigh Simpson MD, Mark B. Landon MD, Henry L. Galan MD, Eric R.M. Jauniaux MD, PhD, Deborah A. Driscoll MD, Vincenzo Berghella MD and William A. Grobman MD, MBA, Seventh, Philadelphia, PA: Elsevier, Inc., 661–705. ISBN 9780323321082. OCLC 951627252. 
  22. ↑ Sanders (August 1991). "Brain in eclampsia: MR imaging with clinical correlation.". Radiology 180 (2): 475–478. DOI:10.1148/radiology.180.2.2068315. ISSN 0033-8419. PMID 2068315. 
  23. ↑ Spurr (June 1900). "Three Cases of Puerperal Eclampsia". The Lancet 155 (4007): 1717–1719. DOI:10.1016/s0140-6736(01)78186-x. ISSN 0140-6736. 
  24. ↑ Wichert-Ana (December 2006). "Epistaxis during a generalized seizure leading to an atypical ictal SPECT finding at the skull base". Journal of Epilepsy and Clinical Neurophysiology 12 (4): 225–227. DOI:10.1590/s1676-26492006000700007. ISSN 1676-2649. 
  25. ↑ 25.0 25.1 Fleisher MD (2018). "Chapter: Eclampsia", Essence of Anesthesia Practice, Roizen, Michael F.,, Roizen, Jeffrey D., 4th, Philadelphia, Pa.: Elsevier Inc, 153–154. ISBN 9780323394970. OCLC 989062320.  Kpọpụta njehie: Invalid <ref> tag; name ":13" defined multiple times with different content
  26. ↑ 26.0 26.1 Bersten (2014). "Chapter 63: Preeclampsia and eclampsia", Oh's Intensive Care Manual, Soni, Neil, Seventh, [Oxford]: Elsevier Ltd, 677–683. ISBN 9780702047626. OCLC 868019515.  Kpọpụta njehie: Invalid <ref> tag; name ":3" defined multiple times with different content
  27. ↑ Robert Resnik (2014). "Chapter 46: Placenta Previa, Placenta Accreta, Abruptio Placentae, and Vasa Previa", Creasy and Resnik's maternal-fetal medicine : principles and practice, Creasy, Robert K.,, Resnik, Robert,, Greene, Michael F.,, Iams, Jay D.,, Lockwood, Charles J., Seventh, 732–742. ISBN 9781455711376. OCLC 859526325. 
  28. ↑ Acog Committee On Obstetric Practice (January 2002). "ACOG practice bulletin. Diagnosis and management of preeclampsia and eclampsia. Number 33, January 2002". Obstet Gynecol 99 (1): 159–67. DOI:10.1016/s0029-7844(01)01747-1. PMID 16175681. 
  29. ↑ ACOG Committee on Obstetric Practice (April 2002). "ACOG practice bulletin. Diagnosis and management of preeclampsia and eclampsia. Number 33, January 2002. American College of Obstetricians and Gynecologists". International Journal of Gynaecology and Obstetrics 77 (1): 67–75. ISSN 0020-7292. PMID 12094777. 
  30. ↑ Sibai (February 2005). "Diagnosis, prevention, and management of eclampsia". Obstetrics and Gynecology 105 (2): 402–410. DOI:10.1097/01.AOG.0000152351.13671.99. ISSN 0029-7844. PMID 15684172. 
  31. ↑ (2011) "Chapter 35: Hypertension", High risk pregnancy : management options, James, D. K. (David K.), Steer, Philip J., 4th, St. Louis, MO: Saunders/Elsevier, 599–626. ISBN 9781416059080. OCLC 727346377. 
  32. ↑ (April 1995) "Blindness associated with preeclampsia and eclampsia". American Journal of Obstetrics and Gynecology 172 (4 Pt 1): 1291–8. DOI:10.1016/0002-9378(95)91495-1. PMID 7726272. 
  33. ↑ 33.0 33.1 James (2011). "Chapter 48: Neurologic Complications of Preeclampsia/Eclampsia", High Risk Pregnancy, Steer, Philip J., 4th, St. Louis, MO: Saunders/Elsevier, 861–891. ISBN 9781416059080. OCLC 727346377. 
  34. ↑ Cronenwett (2014). "Chapter 40: Systemic Complications: Respiratory", Rutherford's vascular surgery, Johnston, K. Wayne, Eighth, Philadelphia, PA: Saunders, Elsevier, 626–637. ISBN 9781455753048. OCLC 877732063. 
  35. ↑ Adams (2013). "Chapter 99: Seizures", Emergency medicine : clinical essentials, 2nd, Philadelphia, PA: Elsevier/ Saunders, 857–869. ISBN 9781437735482. OCLC 820203833. 
  36. ↑ (2014) "Chapter 48: Pregnancy-Related Hypertension", Creasy and Resnik's Maternal-Fetal Medicine : Principles and Practice, Creasy, Robert K.,, Resnik, Robert,, Greene, Michael F.,, Iams, Jay D.,, Lockwood, Charles J., Seventh, Philadelphia, PA: Saunders, an imprint of Elsevier Inc., 756–781. ISBN 9781455711376. OCLC 859526325. 
  37. ↑ Gabbe MD (2017). "Chapter 31: Preeclampsia and Hypertensive Disorders", Obstetrics : Normal and Problem Pregnancies, Jennifer R. Niebyl MD, Joe Leigh Simpson MD, Mark B. Landon MD, Henry L. Galan MD, Eric R.M. Jauniaux MD, PhD, Deborah A. Driscoll MD, Vincenzo Berghella MD and William A. Grobman MD, MBA, Seventh, Philadelphia, PA: Elsevier, Inc, 661–705.e3. ISBN 9780323321082. OCLC 951627252. 
  38. ↑ Gardner (2018). "Chapter 16: The Endocrinology of Pregnancy", Greenspan's basic & clinical endocrinology, Shoback, Dolores M.,, Greenspan, Francis S. (Francis Sorrel), 1920-2016., Tenth, [New York]: McGraw-Hill Education. ISBN 9781259589287. OCLC 995848612. 
  39. ↑ American College of Obstetricians and Gynecologists (June 2020). "Gestational Hypertension and Preeclampsia". Obstetrics & Gynecology 135 (6): e237–e260. DOI:10.1097/AOG.0000000000003891. PMID 32443079. Retrieved on September 12, 2022. 
  40. ↑ Kasper (2015). "Chapter 117: Gynecologic Malignancies", Harrison's principles of internal medicine., Fauci, Anthony S., 1940-, Hauser, Stephen L.,, Longo, Dan L. (Dan Louis), 1949-, Jameson, J. Larry,, Loscalzo, Joseph, 19th, New York: McGraw-Hill Education. ISBN 9780071802154. OCLC 893557976. 
  41. ↑ Murray (2014). "Chapter 102: Pre-eclampsia", Clinical genomics : practical applications in adult patient care, Babyatsky, Mark W.,, Giovanni, Monica A.,, Alkuraya, Fowzan S.,, Stewart, Douglas R., First, New York: McGraw-Hill Education. ISBN 9780071622448. OCLC 899740989. 
  42. ↑ 42.0 42.1 (12 April 2018) Williams obstetrics, Williams, J. Whitridge (John Whitridge), 1866-1931., Cunningham, F. Gary,, Leveno, Kenneth J.,, Bloom, Steven L.,, Spong, Catherine Y.,, Dashe, Jodi S., 25th. ISBN 978-1-259-64432-0. OCLC 958829269. 
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