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Review ofLiterature
which is defined in terms ofthe new development Ollljp-:nl;lIsiun and
proteinuria. (De Swiet, 1995).
Proteinuria:
Protein is always present in urine in small amounts and it increases
in normal pregnancy. The presence ofmeasurable protein can be due to
an increase in the normal renal leakage or a specific increase from renal
damage. The amount of protein found in urine will depend on the amount
passing across the glomerulis and the amount reabsorbed by the tubules.
The classic lesion in pre-eclampsia is glomerular endotheliosis. This is
not a sign of damage but a pathophysiological change that will recover
within days of delivery. It is alway's associated with proteinuria which
consists mostly of albumin that implies leaks across the glomerular
memberance. It is important to note that in more severe disease,
proteinuria is less specific being associated with tubular proteins (James,
1998).
Edema:
The pathological edema of preeclampsia is easily confused with
physiological edema found in 80% of normal pregnant women
physiological edema has not been shown to be precursor ofpathological
edema (De Swiet, 1995).
In one of the prospective studies, pregnant women with no edema
or early and late onset edema, all had a similar incidence of preeclampsia
(Robertson, 1971).
During normal pregnancy there is a moderate fall in colloid
osmotic pressure of the plasma and rise in hydrostatic pressure in the
capillaries. This tends to increase fluid filteration from the intravascular
compartments, but this is compensated by fluid reabsorption . For all
these reasons, the detection ofedema is not useful clinically, nor should
edema be included in the definition' of preeclampsia. Development of
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