Talk:Eclampsia

From WikiProjectMed
Jump to navigation Jump to search

Wiki Education Foundation-supported course assignment

This article was the subject of a Wiki Education Foundation-supported course assignment, between 1 July 2019 and 23 August 2019. Further details are available on the course page. Student editor(s): Jiangyad, Zaccarlson, Nzargham, Terry.vo. Peer reviewers: Francesca.alcala.96, Mvirk422, Vivianle17.

Above undated message substituted from Template:Dashboard.wikiedu.org assignment by PrimeBOT (talk) 20:24, 17 January 2022 (UTC)[reply]

Wiki Education Foundation-supported course assignment

This article is or was the subject of a Wiki Education Foundation-supported course assignment. Further details are available on the course page. Student editor(s): DrKMD. Peer reviewers: Emb47.

Above undated message substituted from Template:Dashboard.wikiedu.org assignment by PrimeBOT (talk) 20:02, 16 January 2022 (UTC)[reply]

Hypoperfusion

This term occurs in the article, but it is not defined in the article. There is also no link to a definition. A search for "hypoperfusion" in wikipedia leads to an article on ischemia. It appears that they are synonyms, but I don't have the required medical knowledge. Ileanadu (talk) 02:17, 10 December 2008 (UTC)[reply]

Preeclamptic Symptoms

I think what some of the above entries are getting at is that these women apparently had no prior symptoms, or didn't recognize them, which is contradicted by the statement that:

   "rarely does eclampsia occur without preceding preeclamptic symptoms"

Ileanadu (talk) 02:25, 10 December 2008 (UTC)[reply]

The above are compelling anecdotes but that is why it says rarely, not never. Ψαμαθος 08:26, 10 December 2008 (UTC) —Preceding unsigned comment added by Psamathos (talkcontribs)

Risk Factors

There appears to be a typo error at the end of this section. It reads: "Most cases result of aggressive use of crystalloid solutions for intravascular volume expansion." I am unable to guess at the intended meaning, so I am not sure how to correct it. Can anyone else figure it out?

Eclampsia in Animals

Is this worth mentioning here? Hypocalcaemia in dogs is referred to as eclampsia/peuperal tetany when it occurs due to their lactation (doesn't usually happen at birth like it does in people). Brionyvet (talk) 22:45, 9 September 2010 (UTC)[reply]

Edits to talk page

Deleted several personal stories from this talk page. Please see in the directions above, this is not a forum. It is for discussion about editing the article. 98.232.225.61 (talk) 17:35, 17 November 2013 (UTC)[reply]

Convulsions section edit needed

In the Convulsions section, there appears to be an incomplete sentence:

Prevention of convulsion is usually done using magnesium sulphate. The idea to use Mg2+ for the management of eclamptogenic toxemia dates from before 1955 when it was tested and published—the serum The international MAGPIE study, of 2004, evaluated the long-term implications of the magnesium sulphate therapies.

Note that something needs to follow "the serum"; "The international MAGPIE study..." begins a new sentence. It's also unclear what was tested and published—what does the "it" refer to? The idea? Very confusing; more clarity would be helpful. I have tried to find relevant information; I think what is being referenced is the serum test for protein in the urine, but I don't have the necessary knowledge to complete the sentence. I will check the edit history to see if part of the sentence was inadvertently removed accidentally. —D'Ranged 1 talk 13:22, 26 April 2014 (UTC)[reply]

  • I went back through the edit history and found the missing text. The editor was attempting to remove dosage information, per MEDMOS, but deleted far too much information. It makes sense now, but someone with more knowledge might want to check it. I would caution against removing the information on therapeutic serum levels; these are not doses of magnesium sulfate (which is the information that has been removed), but serum levels that lead to specific symptoms. I also deleted an instance of "convulsions and seizures", since a previous editor noted that they are medically the same thing. They intimated that "convulsions" was the medical term, but I found "seizure" used widely in the article, including a link to a separate article on Tonic-clonic seizures, so I removed "convulsions" and left "seizures". If someone objects, it would be good to use the same terminology throughout, in my opinion.—D'Ranged 1 talk 13:49, 26 April 2014 (UTC)[reply]

Archtypically Bad Article

This article needs a serious re-write. It suffers badly from a disease common on wikipedia: it is written by experts *for* experts. Wikipedia is an *encyclopedia*, not a medical textbook. One should not need to already have a degree in medicine to understand the article. I mean, seriously, what lay person coming to this article is already going to be familiar with words and phrases such as "pathophysiological process", "toxemic changes", "crystalloid solutions for intravascular volume expansion", "immunologically mediated", "vasoactive agents", "altered atrioventricular conduction", or "intubation and mechanical ventilation as adjuvants"? Seriously? If I were a pregnant woman and my doctor started decribing my conditions in such terms, I'd run out and get another doctor! "adjuvants"??? What percent of the population do you think knows the word "adjuvant"??? I'm not even talking about the great unwashed masses. What percentage of *Harvard* graduates do you think knows the word "adjuvant"??? Stop showing off how smart you are and write an article that a reasonably educated person can understand. — Preceding unsigned comment added by 71.212.36.210 (talk) 17:41, 5 December 2014 (UTC)[reply]

Your comments in my view are spot on. I will begin to mold the article toward the general biology high school student, who I believe should be the prototype target for all Wikipedia science and medicine articles. I would like your feedback when I am finished: it will take awhile. Also, I would urge you to choose and use a Username so I can relate to you as a person not a number. Then become an editor! You can start by looking up the definition of adjuvant and replacing it with a simpler term that you choose. Incidentally, the "you" you are addressing is actually 224 people who have made 422 revisions over 12 years. I just spent 15 minutes editing and am now the number 6 top all-time editor by number of edits! Regards, IiKkEe (talk) 19:14, 8 February 2015 (UTC)[reply]


Work Plan

In the next 4 weeks I will be working on this article as part of the course curriculum at my medical university. I hope to improve this article by:

Expanding the existing sections

Adding further citations to reliable outside sources and embedding links to other Wiki pages to support the background information presented

Editing the existing content to decrease the amount of medical jargon and thus make it more understandable for laypersons.

There are multiple sections of this article that could benefit from expansion, and I plan to begin by adding to the sections which are currently shortest: 'Risk Factors', 'Prevention', and 'Diagnosis'. I plan to include information on screening in the 'Prevention' section. The 'Diagnosis' section needs a more detailed differential diagnosis subheading and information on what testing results are diagnostic rather than just a listing of possible tests alone. I will continue with an overhaul of the 'Signs and Symptoms' and 'Treatment' sections to make them easier to read for the general public by converting much of the jargon to plain English. The 'Signs and Symptoms' section could benefit from the addition of a 'Complications' subheading. Once these changes are complete I may add more sections to the article as time permits, including 'Special Populations', 'Epidemiology', and 'History'.

I will specifically exclude overly detailed information on the pathophysiology of eclampsia, which is not only poorly understood by the medical and scientific communities to date but also of little utility to the general audience for this article. I will also exclude specific medical recommendations, as I would not want to lead any readers to believe that they could manage their own illness by way of this article rather than consulting a physician in person, as that is not this article's purpose.

I have a host of available resources to tackle this project via my university, and I will focus first on background information from online search engines including ClinicalKey, AccessMedicine, and MedlinePlus and move on to more foreground information from PubMed and Scopus, specifically data from the most recent systematic reviews and meta-analyses on eclampsia. I will also make use of Plain Language writing guides and medical dictionaries in an effort to avoid complicated medical terminology. Please reach out as I am editing if you have any suggestions to help me improve the article or any comments on my ongoing work!

Thank you. --DrKMD (talk) 20:22, 20 November 2017 (UTC)[reply]

When you use books can you make sure you add page numbers? Or chapters at least?
We often include medical recommendations but if controversial attribute them to the source in question.
For example we say "Recommendations for prevention include aspirin in those at high risk, calcium supplementation in areas with low intake, and treatment of prior hypertension with medications."
Best Doc James (talk · contribs · email) 04:12, 29 November 2017 (UTC)[reply]
Doc James, thank you for the suggestion! I will make every effort to include specific page numbers in my citations.
Much appreciated DrKMD (talk) 21:47, 3 December 2017 (UTC)[reply]
Great work so far with your plan and improvements to the articles. I made some adjustments to the risk factor paragraph and added a few "citation needed" tags. Would you be able to review these? I also removed a 1969 journal article from this paragraph and replaced it with a citation needed tag. If you cannot find a source, we should remove the sentences for now. Thanks again. We appreciate your assistance improving the content of these articles. JenOttawa (talk) 02:24, 4 December 2017 (UTC)[reply]

Peer Review

Here is my review of the Eclampsia article for the WikiEd course: I think that the opening section is really well done as it explains exactly what eclampsia is in very simple and concise terms while keeping the information relevant and accurate. I found nothing in this article distracting from the main topic.

I really like the definitions/clarifications provided in parentheses after terms that could be unknown by people reading who are not in the medical field. I also think that an appropriate number of terms are embedded. The mechanism section is the only one with a lot of medical jargon but that I can see how that would be hard to get around with this topic and all of the terms that could be confusing are embedded.

Throughout the article the information provided in each section is relevant to the disease process and maintains a neutral tone. If I was not aware of the controversy surrounding eclampsia and was reading about it for the first time I would not have thought any existed. There were no conflicting statements and the definitions were very straightforward. I don’t think any view points were over or under represented. I think it's really helpful that the information is derived from both OB and neurology resources.

I think the whole article is referenced appropriately and often. The sources clearly support all of the claims in the article that were derived from them. After going through the reference section it was easy to access the information from the links. Many of the pages provided are specific enough to actually find the information. The few resources that were from over 10 years ago were used to get information that is still in practice today like for the use of magnesium sulfate for pre-eclampsia management. I think the whole article is referenced appropriately and often. The sources clearly support all of the claims in the article that were derived from them.

In terms of organization, I think the majority is great in that each point is broken up nicely into the sections rather than having a bunch of long paragraphs. The risk factors section I think could be in list form, just for style points.

What i think could be added: - Although the terms for the LFT’s and RFT’s and coagulation screen are embedded in the laboratory test section I think it might be useful to provide how they will be abnormal in eclampsia specifically. This might be too specific for what the article is trying to provide but just a thought. - Outcomes section for the future pregnancies of women who have an episode of eclampsia, maybe it could even go in the monitoring section when talking about future check ups.

I think that the work you have done in the article lines up with the work plan you set out at the beginning of the block. Great job it looks awesome! --Emb47 (talk) 03:12, 10 December 2017 (UTC)[reply]

Thank you for the kind peer review! I found your assessment and feedback really encouraging! I agree that the 'mechanism' section is jargon-dense; I had hoped to edit it to contain more understandable plain language and got distracted with adding content to shorter sections which appeared to need more help. I ended up leaving the mechanism section as it existed before I started working on the article, but I may try to go back in the final days and make a few changes if possible. I think that your idea for adding an outcomes section for the future pregnancies of women who have had eclampsia is a great idea, and I will try to incorporate it into the existing 'prevention' section!
Thank you for the suggestions and the thoughtful review! --DrKMD (talk) 00:31, 14 December 2017 (UTC)[reply]

Foundations 2 2019, Group 8a goals

  • Expand on complications related on labor and delivery. In particular, focus on factors that contribute to the decision to deliver.
  • Expand on treatment options related to labor and delivery.
  • Expand on treatment options related to blood pressure management including thresholds and other pharmacological options

Terry.vo (talk) 21:04, 30 July 2019 (UTC)[reply]

Foundations 2 2019, Group 8c Peer Review, Vivian

The group has achieved its goal for expanding on L&D complications and treatment by talking about fetal bradycardia and how that leads to C-section if not resolved in 15 minutes. However, I will say that Jane and Zac’s edits were in conflict because Zac seemed to say that C-sections are generally preferred in the face of specific complications. A clarifying additional sentence on how there may be a preferred delivery mode for particular complications of eclampsia but not for eclampsia in general. Terry’s edits on BP control to include why BP control is important and when it is indicated will be extremely helpful for patients to both be more concerned about their BP but not overly slow if their BP is only slightly elevated. This draft submission reflects a neutral point of view for treatment options with no strong advocation for one treatment over other viable treatments.

Vivianle17 (talk) 20:52, 5 August 2019 (UTC)[reply]

Foundations 2 2019, Group 8C peer review, Mehr

The group addressed their first goal of expanding on the decision to deliver by explaining how a bradycardic fetal heartbeat warrants a C-section if not resolved in 15 minutes. Their second goal of expanding on treatments could be elaborated more on as a previous editor mentioned the 4 goals but there was no mention of how one goes about addressing these goals. Their third goal about high blood pressure thresholds and management options was pointed out by other editors but there could be room for elaboration in why hydralazine is suggested or what to do if a pregnant patient is already on a medication for high blood pressure. This group's additions to the text fell in line with the Wikipedia manual of style. They used the proper sentence structure and followed the steps for proper citations.

Mvirk422 (talk) 02:13, 6 August 2019 (UTC)[reply]

Foundations 2 2019, Group 8b Peer Review, Francesca(8C)

Do the group’s edits substantially improve the article as described in the Wikipedia peer review “Guiding framework”?

The group was able to achieve its first goal by elaborating when delivery is necessary.There could be further elaboration on treatment options in labor and delivery and specifically with blood pressure to help readers have a better understanding of the measures taken to prevent emergency delivery.

Has the group achieved its overall goals for improvement?
The group achieved it's first goal but more elaboration is necessary for other goals.

Are the points included verifiable with cited secondary sources that are freely available? If not, specify…
Each of their additional edits has proper citations that are freely available and qualify under the Wikipedia guidelines.

Queen's University Student Editing Initiative

Hello, we are a group of medical student’s from Queen’s University. We are working to improve this article over the next month and will posting our planned changes on this talk page. We look forward to working with the existing Wikipedia medical editing community to improve this article and share evidence. We welcome feedback and suggestions as we learn to edit. Thank you. Gezheng (talk) 20:15, 23 November 2020 (UTC)[reply]

Mechanism

We noticed that although it is explained in the “Mechanism” section that reduced blood flow to the placenta is a key feature in the process of eclampsia pathogenesis, there was no example of why this may occur. We propose to include the sentence, “Vascular dysfunction-associated maternal conditions such as Lupus, hypertension, and renal disease, or obstetric conditions that increase placental volume without an increase in placental blood flow (such as twin pregnancy) can increase risk for pre-eclampsia.[1]

It was also noticed in the “Mechanism” section that reference 39 is outdated (from 1997) and the sentence, “The invasion of the trophoblast appears to be incomplete” is more confusing than explanative. We propose the sentence, “Pre-eclampsia’s pathogenesis is poorly understood, but it likely only involves maternal and placental factors because it is only seen in molar pregnancies absent of fetal tissue, containing only trophoblastic tissue [2]” be added in its place, and that reference 39 is removed. The reference for the replacement is also from Patel et al. in 2017, which provides a more recent source. The word “trophoblast” in this section will also be linked to the Wiki page “Trophoblast”, to provide more background information for those who wish to view it, just as the current sentence does. Ethanpatterson1 (talk) 07:29, 3 December 2020 (UTC)[reply]

Great work here. Note: Multiple use of the same reference- tech tip. When you add your references while editing, you can see the options "automatic... Manual... Re-use". The first time you add the citation (if it is not already used in an article, click "automatic" and add your PMID, DOI, or website, then click "generate" to fill the template. The second time you want to use the same citation in an article, click "reusue" and search for your citation in the list. This adds in the a,b,c versus duplicating the citation in the list. If possible, practice this in your sandbox before editing live on Monday.
Also, for the text book, please include page #s in your actual wikipedia article edit, if available (pages you found evidence on).JenOttawa (talk) 04:35, 5 December 2020 (UTC)[reply]

References

  1. ^ Patel, Bansari; Nitsche, Joshua F.; Taylor, Robert N. (2017). "Chapter 16: The Endocrinology of Pregnancy". In Gardner, David G.; Shoback, Dolores (eds.). Greenspan's Basic & Clinical Endocrinology (Book Section) (10 ed.). New York, NY: McGraw-Hill Education.
  2. ^ Patel, Bansari; Nitsche, Joshua F.; Taylor, Robert N. (2017). "Chapter 16: The Endocrinology of Pregnancy". In Gardner, David G.; Shoback, Dolores (eds.). Greenspan's Basic & Clinical Endocrinology (Book Section) (10 ed.). New York, NY: McGraw-Hill Education.

Diagnosis

Proposed Changes: Delete the first sentence ("The hallmark symptom..."). Insert "while seizures are most common in the third trimester, they may occur any time from 20 weeks of pregnancy until 6 weeks after birth" [1] as the second sentence.

It is important to make the distinction between pre-eclampsia and eclampsia very clear, specifically that eclampsia is the occurrence of a seizure in a patient with diagnosed pre-eclampsia. The second sentence does this well and will be moved to the top. The first sentence, which we propose should be deleted, is ambiguous but introduces an important point about the timing of seizures. A sentence will be added to clarify the time-frame in which eclamptic seizures are observed. CMorrison2020 (talk) 15:10, 3 December 2020 (UTC)[reply]

Please see comments in other sections about adding references using the tool and practicing in your sandbox! Your citation looks good in the box below, however it is not formatted with the proper tool, from what I can see. If you need help please let me know!JenOttawa (talk) 04:37, 5 December 2020 (UTC)[reply]

References

  1. ^ Rogers V.L., & Roberts S.W. (2021). Preeclampsia-eclampsia. Papadakis M.A., & McPhee S.J., & Rabow M.W.(Eds.), Current Medical Diagnosis & Treatment 2021. McGraw-Hill.

Signs & Symptoms

My proposed changes are adding to the signs and symptoms section to include the vital sign of 140/90 mmHg as a sign of pre-eclampsia: “Repeated blood pressure measurements of 140/90mmHg is indicative of pre-eclampsia.”

This sentence will follow “Eclampsia is a disorder of pregnancy characterized by seizures in the setting of pre-eclampsia.”

I decided that this change was necessary because the elevated blood pressure is a vital sign that is used to diagnose pre-eclampsia which can become eclampsia with the onset of seizures. Although there is a section under “diagnosis” that references blood pressure, there is currently no mention of this in the signs and symptoms section. This information is from the textbook source’s comment that, “Repeated blood pressure readings of 140/90 mm Hg taken 6 hours apart should be considered evidence of preeclampsia when found after 20 weeks”. [1] Gezheng (talk) 15:56, 3 December 2020 (UTC)[reply]

Thanks for sharing this @Gezheng: do you mind adding your textbook citation using the tool that we practiced in the wiki skills session? This will ensure it is formatted properly in the actual article. It is not as important here on the talk page, but please practice here or in your sandbox to ensure that it will look good in your final article improvement on Monday. Also, if your textbook has page #s, please include the pages that you found this evidence. Not all online books do, so please disregard if this is not the case.JenOttawa (talk) 14:30, 5 December 2020 (UTC)[reply]

References

  1. ^ Mehta S.H., & Sokol R.J. (2019). Assessment of at-risk pregnancy. DeCherney A.H., & Nathan L, & Laufer N, & Roman A.S.(Eds.), CURRENT Diagnosis & Treatment: Obstetrics & Gynecology, 12e. McGraw-Hill. https://accessmedicine-mhmedical-com.proxy.queensu.ca/content.aspx?bookid=2559&sectionid=206958883

Prevention

Proposed Changes:

1. Adding a reference for the claim that magnesium sulfate is used to prevent convulsions in women with pre-eclampsia and changing wording.

"Appropriate management of women with pre-eclampsia generally involves the use of magnesium sulfate to prevent eclamptic seizures.[1]"

I've chosen to change the word "convulsions" to "eclamptic seizures" in order to be more specific. I hope that this will also kickstart a general attempt to differentiate pre-eclampsia from eclampsia, something that could be improved in the article as a whole.

2. Adding a sentence regarding low-dose aspirin to follow the change I've described above.

"In some cases, low-dose aspirin has been shown to decrease the risk of pre-eclampsia in pregnant women, especially when taken in the late first trimester[2]" The use of aspirin in prevention of pre-eclampsia is mentioned in the opening paragraph, but does not appear in the Prevention section.Exmeng (talk) 16:17, 3 December 2020 (UTC)[reply]

Thanks for sharing this. Please be sure to add your citation using the tool as demonstrated in class (pasting in the PMID/DOI to autogenerate the entry in the correct format. Please practice in your sandbox to be ready to edit the article on Monday.JenOttawa (talk) 04:31, 5 December 2020 (UTC)[reply]
I have one other small note. That is great that you are re-using your citation after each sentence- wiki style (Mehta et al 2019). I have a small tech tip. If you plan to re-use your citation more than once in the article, here are some basic instructions: When you add your references while editing the actual article, you can see the options "automatic Manual Re-use". The first time you add the citation (if it is not already used in an article, click "automatic" and add your PMID, DOI, or website, then click "generate" to fill the template. The second time you want to use the same citation in an article, click "re-use" and search for your citation in the list. This adds in the a,b,c versus duplicating the citation in the list. If possible, practice this in your sandbox before editing live on Monday. Thanks again!

References

  1. ^ Barbieri R.L., & Repke J.T. (2018). Medical disorders during pregnancy. Jameson J, & Fauci A.S., & Kasper D.L., & Hauser S.L., & Longo D.L., & Loscalzo J(Eds.), Harrison's Principles of Internal Medicine, 20e. McGraw-Hill.
  2. ^ Mehta S.H., & Sokol R.J. (2019). Assessment of at-risk pregnancy. DeCherney A.H., & Nathan L, & Laufer N, & Roman A.S.(Eds.), CURRENT Diagnosis & Treatment: Obstetrics & Gynecology, 12e. McGraw-Hill.

Treatment

Proposed Changes 1. Delete and replace the following: “Serum magnesium concentrations associated with maternal toxicity as well as neonatal respiratory depression, low muscle tone, and low Apgar scores[48] are: • 7.0–10.0 mEq/L: loss of patellar reflex • 10.0–13.0 mEq/L: respiratory depression • 15.0–25.0 mEq/L: altered atrioventricular conduction and (further) complete heart block • >25.0 mEq/L: cardiac arrest”

It will now be replaced with a sentence following this: "With intravenous administration, the onset of anticonvulsant action is fast and lasts about 30 minutes….. proportional to the plasma concentration and glomerular filtration.[49]" My addition: Magnesium sulfate is associated with several minor side effects; serious side effects are uncommon, occurring at serum concentrations > 7.0 mEQ/L. Serious toxicity can be counteracted with calcium gluconate. [1]

Toxicity is a rare incident and toxic serum concentrations are unnecessary in this section, one sentence on this is sufficient with the addition of information about the antidote.

2. Move the sentence “Effective anticonvulsant serum levels range from 2.5 to 7.5 mEq/liter” after:

The study demonstrating the effectiveness of magnesium sulfate for the management of eclampsia was first published in 1955.[47] “Effective anticonvulsant serum levels range from 2.5 to 7.5 mEq/liter.[49]” For logical flow, effective serum levels should be mentioned before the discussion about the onset of magnesium sulfate and how it’s excreted. Eclampsia2020 (talk) 17:41, 3 December 2020 (UTC)[reply]

Thanks for this information. When editing the actual article, please be sure to add your citations in the correct format, using the tool that we practiced in the wiki skills lecture. JenOttawa (talk) 04:31, 5 December 2020 (UTC)[reply]

References

  1. ^ Smith, J. M., Lowe, R. F., Fullerton, J., Currie, S. M., Harris, L., & Felker-Kantor, E. (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(1). https://doi.org/10.1186/1471-2393-13-34

Risk Factors

Proposed Changes:My proposed changes are to the risk factors section.

Following the sentence: "Women who have experienced eclampsia are at increased risk for pre-eclampsia/eclampsia in a later pregnancy." I will add the following: "People of certain ethnic backgrounds can have an increased risk of developing pre-eclampsia and eclampsia. The occurrence of pre-eclampsia was 5% in white, 9% in Hispanic, and 11% in African American women. Black women were also shown to have a disproportionately higher risk of dying from eclampsia." [1] Gabrielee.j (talk) 18:33, 3 December 2020 (UTC)[reply]

Thanks for sharing this. Please be sure to add your citation using the tool as demonstrated in class (pasting in the PMID/DOI to autogenerate the entry in the correct format. Please practice in your sandbox to be ready to edit the article on Monday.JenOttawa (talk) 04:31, 5 December 2020 (UTC)[reply]

Wiki Education assignment: UCSF SOM Inquiry In Action-- Wikipedia Editing 2022

This article was the subject of a Wiki Education Foundation-supported course assignment, between 8 August 2022 and 20 September 2022. Further details are available on the course page. Student editor(s): Asingh238, Y.s.a.law, Aevallej, Ella.olgin (article contribs). Peer reviewers: AN ucsf, Mitac10, CNICHOLAS6533.

— Assignment last updated by Mitac10 (talk) 06:05, 18 September 2022 (UTC)[reply]

Workplan for WikiEdits Project UCSF Fall 2022

We are a group of medical students from the University of California, San Francisco. Our goals for this article include improving the overall cohesiveness and flow of the article, updating citations, and including inclusive and non-gendered language in reference to the patient population with eclampsia. Each of our group members will focus and make edits to one section. The sections include the introduction, mechanism, diagnosis and treatment, and signs and symptoms. Our work plan is as followed:

Work Plan
General edits:

  • Removing gendered language
  • Updating citations

Introduction:

  • Clarify sentences and improve paragraph flow

Signs and symptoms:

  • Update/add characteristics of eclampsia
  • Differentiate between signs and symptoms and diagnostic criteria

Risk Factors:

  • Remove language attributing race as a risk factor

Mechanism:

  • Update mechanism
  • Add clarifying sentence that the mechanism is not well understood

Diagnosis:

  • Clarify vital signs (define blood pressure, make sentence structure clearer)
  • Add citations

Treatment:

  • Clarify sentence structure
  • Define a few medical terms

— Preceding unsigned comment added by Y.s.a.law (talkcontribs) 17:53, 16 September 2022 (UTC)[reply]

— Assignment last updated by Asingh238 (talk) 17:04, 14 September 2022 (UTC)[reply]

UCSF SOM Inquiry in Action, Peer Review 2022 - Aishwarya

Lead:

  • A suggestion might be to clarify the introductory sentence as the understanding of eclampsia is currently dependent on having a clear understanding of pre-eclampsia. A suggestion might be to explain that eclampsia is a progression of pre-eclampsia, and includes the signs and symptoms of pre-eclampsia with the development of seizures.
  • A potential addition might also be the natural course of disease and how it leadsto death of the parent and fetus
  • I like the updated language which reflects inclusivity!

Content

Signs and Symptoms
  • In signs and symptoms, it may be helpful to have a sentence about what the triad of symptoms for pre-eclampsia is to illustrate the eclampsia is the same but with seizures, and a progression of that disease state
  • It could also be helpful to note what trimester/time of pregnancy one should be worried about the symptoms of eclampsia
  • I would suggest adding some WIkilinks to the signs and symptoms as some clinical language is used and it might help to break those down for patients seeking explanation (ie Photophobia, altered mental status)
  • Consider citing a source for the last comment about the cerebral signs preceding the convulsion.

Onset

  • I like that there is a section for onset because time course is important in consideration of treatment modalities (ie immediate delivery)
  • I would suggest adding in more exact onset of eclampsia, and adding weeks of pregnancy to be exact with timing to be clinically relevant for patients
  • Potentially adding in when patients are typically monitored for pre-eclampsia and how they are monitored might be helpful

Characteristics

  • This section could have more Wikilinks to symptoms for people to easily look up signs/symptoms.

Tone and Balance

  • Great tone and balance of sources throughout the article! The article took a very neutral standpoint which is helpful to readers.
  • The content doesn't seem to sway towards one side or the other, and doesn't persuade the readers of a specific viewpoint

Sources

  • Consider adding in more diverse sources within the mechanism section as it generally borrows from one main source.
  • The source for the epidemiology cited in the introduction ("Pre-eclampsia is estimated to globally affect about 5% of deliveries") is from 2013, so it might be helpful to look at current global burden of disease.

Organization

  • The section headers are very useful for patients to find information that is going to be useful for them, like symptoms and complications.
  • Consider bringing the risk factors section up higher closer to signs and symptoms, or within signs and symptoms, so the symptoms and progression of disease have more context.
  • The content is concise and is not overly wordy, which gets across needed information to readers.
  • Consider splitting the consequences into parental and fetal consequences

Great job overall on editing the article, hopefully some of these suggestions help out with the editing process! AN ucsf (talk) 06:00, 17 September 2022 (UTC)[reply]

--AN ucsf (talk) 06:01, 17 September 2022 (UTC)[reply]

UCSF SOM Inquiry in Action, Peer Review 2022 - Laksmita

Intro

  • Consider defining edema or providing a link
  • Does blood pressure medications actually treat preeclampsia or does it reduce the risk of the cardiovascular events (ie. Strokes) that may occur with preeclampsia? I'm referring to this sentence: "Treatment options include blood pressure medications such as hydralazine and emergency delivery of the baby either vaginally or by cesarean section."

Risk factors

  • Consider listing out the various list factors and descriptions in bullet point format so it's easier to read/digest

Laboratory testing

  • Consider specifying what kind of abnormal lab values are associated with pre-eclampsia (ie. Hemolytic anemia, elevated liver enzymes, high creatinine, etc)

Treatment

  • Consider expanding this section and adding citations

General comments

  • Appreciate the gender inclusive language throughout
  • Great job at using neutral language
  • The "Complications" section did a really good job of explaining complex medical diseases and outcomes in simpler language
  • The Pop Culture section is fun!
  • Some information lack citations (treatment section, first paragraph of delivery section), though this was not written by the medical students involved in this project

Great job editing! Mitac10 (talk) 05:15, 18 September 2022 (UTC)[reply]

UCSF SOM Inquiry in Action, Peer Review 2022- Catherine

Intro:

Good, concise, includes some epi, Maybe consider reorganizing the intro summary to have the epi stuff first and the word origination stuff first so that it doesn't feel so tacked on at the end. Maybe add a sentence about what ethnic/racial groups have a greater mortality rate when discussing deaths associated with eclampsia

Is the prevalence of eclampsia decreasing or increasing? are more pregnant persons in recent years being diagnosed?

Content

- Signs and Symptoms: Consider changing the image associated with this section to be a graphic showing how prevalent having some of these symptoms is prior to the seizure are. I don't really think that a visual of the quadrants is that helpful for having a deeper understanding of this pathology.

- Differential Diagnosis: It states that the eclampsia seizures need to be distinguished from any other seizure inducing conditions, may be worth while to state how they distinguish between those seizures

Tone

- Tone is very informational and professional.

- Jargon is utilized but you often have more lay terminology in (...)

Organization

- Consider revising the organization of the article as a whole. Going from section to section does feel a bit disjointed. I would suggest that the differential diagnosis is higher up in the article. (maybe having the differential up top and then hone in on the mechanism and then signs and symptoms and then treatment, etc.)

General Comments:

- Non gendered language is consistent throughout article and not in an overly wordy way- Great job


CNICHOLAS6533 (talk) 13:19, 19 September 2022 (UTC)[reply]

  1. ^ Hypertensive disorders. Cunningham F, & Leveno K.J., & Bloom S.L., & Dashe J.S., & Hoffman B.L., & Casey B.M., & Spong C.Y.(Eds.), (2018). Williams Obstetrics, 25e. McGraw-Hill. https://accessmedicine.mhmedical.com/content.aspx?bookid=1918&sectionid=169756263