Preeclampsia Treatment and Management


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Evidence Based - Facts Checked

This content is medically reviewed by Dr. Akanksha Bansal (MBBS, DNB (OBS & GYNE)) and written by Dr. Vijaya Dutta (BDS)

Last Medical Review Date - 10th November 2020


Preeclampsia is a medical condition characterized by hypertension in a pregnant woman. Presence of protein in urine and organ damage in extreme conditions are some of the symptoms of preeclampsia during pregnancy. 

Preeclampsia Symptoms

Preeclampsia should be taken seriously as it causes around 60,000 fatalities world wide1Duhig, K., Vandermolen, B., & Shennan, A. (2018, February 28). 'Recent advances in the diagnosis and management of pre-eclampsia' Source.

How is Preeclampsia During Pregnancy Treated/ Managed?

Depending upon the severity of Preeclampsia, one or combination of the following treatment plan shall be instructed by your gynecologist:-

1. Regular Visit to Gynecologist

 A regular visit to your gynecologist is advised to keep a check on various symptoms and to evaluate fetus’ growth. This helps in making informed decisions if required2Sibai, Baha & Stella, Caroline. (2010). 'Diagnosis and Management of Atypical Preeclampsia-Eclampsia. Obstetric Anesthesia Digest'.  Source

2. Control of Blood Pressure

Target blood pressure should be less than 150 mmHg (systolic blood pressure) and 80 -100 mmHg (diastolic blood pressure) to treat Preeclampsia during pregnancy3Duhig, K., Vandermolen, B., & Shennan, A. (2018, February 28). 'Recent advances in the diagnosis and management of pre-eclampsia'  Source.

Doctors do not recommend antihypertensive in females with mild preeclampsia ( blood pressure less than 160/110 mm Hg ); however, If blood pressure is more than 160/110 mmHg, your physician may prescribe antihypertensive4CM;, B. E. (2014). 'Treatment of preeclampsia: Current approach and future perspectives' Source.

It is essential to share your complete medical history with your gynecologist, as certain antihypertensive like labetalol is not recommended if the patient is asthmatic or has heart disease5Wagner, L. K. (2004, December 15). 'Diagnosis and Management of Preeclampsia' Source.

3. Medications


 Magnesium Sulfate

Magnesium Sulfate helps decrease the risks of developing a severe form of eclampsia and eventually lower the mother’s risk of death6CM;, B. E. (2014). 'Treatment of preeclampsia: Current approach and future perspectives' Source. It also helps in managing seizure prophylaxis in severe cases of preeclampsia during pregnancy7Cipolla, M. J., & Kraig, R. P. (2011, May). 'Seizures in Women with Preeclampsia: Mechanisms and Management' Source.

Corticosteroids

Fetus’ lungs do not mature if the pregnant mother happens to suffer from preeclampsia during pregnancy8Winn HN;Klosterman A;Amon E;Shumway JB;Artal R;. (2000). 'Does preeclampsia influence fetal lung maturity?' Source. Your gynecologist might prescribe corticosteroid injections between the 24th and 36th week of pregnancy to help your fetus’ lung develop properly or if premature delivery is being planned for high risk cases9Peres, G. M., Mariana, M., & Cairrão, E. (2018, January 17). 'Pre-Eclampsia and Eclampsia: An Update on the Pharmacological Treatment Applied in PortugalSource.


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4. Hospitalization

Hospitalization is recommended for patients in cases of progressive / severe preeclampsia.

What to expect when hospitalized?

- A regular check on preeclampsia symptoms, such as headache, rapid weight gain, visual disturbances, pain below ribs, etc.

- BMI and blood pressure shall be checked regularly.

- Analysis of protein in urine, liver enzymes and creatine levels shall be done at regular intervals to check the progress of the treatment.

 - If edema is not present, your gynecologist may decide to prescribe intravenous administration of fluids to maintain the urine output. The aim is to keep the urine output more than 100 ml every 4 hours10Anthony, J., & Schoeman, L. K. (2013, September). 'Fluid management in pre-eclampsia' Source.

- Physical examination and sonography shall be done by the gynecologist to check the fetus’ growth.

- In case if the conditions become severe, your gynecologist may decide to go for preterm delivery. 



References

  1. 1
    Peres, G. M., Mariana, M., & Cairrão, E. (2018, January 17).
    Pre-Eclampsia and Eclampsia: An Update on the Pharmacological Treatment Applied in Portugal.
    Retrieved November 10, 2020, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5872351/
  2. 2
    Duhig, K., Vandermolen, B., & Shennan, A. (2018, February 28).
    Recent advances in the diagnosis and management of pre-eclampsia.
    Retrieved November 10, 2020, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5832913/
  3. 3
    Sibai, Baha & Stella, Caroline. (2010).
    Diagnosis and Management of Atypical Preeclampsia-Eclampsia. Obstetric Anesthesia Digest. 30. 12-13. 10.1097/01.aoa.0000366992.20321.da.
    Retrieved November 10, 2020, from https://www.researchgate.net/publication/275115516_Diagnosis_and_Management_of_Atypical_Preeclampsia-Eclampsia
  4. 4
    CM;, B. E. (2014).
    Treatment of preeclampsia: Current approach and future perspectives.
     Retrieved November 10, 2020, from https://pubmed.ncbi.nlm.nih.gov/25135649/
  5. 5
    Wagner, L. K. (2004, December 15).
    Diagnosis and Management of Preeclampsia.
    Retrieved November 10, 2020, from https://www.aafp.org/afp/2004/1215/p2317.html
  6. 6
    Cipolla, M. J., & Kraig, R. P. (2011, May).
    Seizures in Women with Preeclampsia: Mechanisms and Management.
     Retrieved November 10, 2020, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3119563/
  7. 7
    Winn HN;Klosterman A;Amon E;Shumway JB;Artal R;. (2000).
    Does preeclampsia influence fetal lung maturity?
    Retrieved November 10, 2020, from https://pubmed.ncbi.nlm.nih.gov/10923304
  8. 8
    Anthony, J., & Schoeman, L. K. (2013, September).
    Fluid management in pre-eclampsia.
    Retrieved November 11, 2020, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5032921/

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This content is only for educational purpose and should not be considered as a substitute for your Physician's/Doctor's clinical judgement

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