Preeclampsia Management

Preeclampsia is a serious pregnancy complication characterized by high blood pressure and protein in the urine that typically develops after 20 weeks of pregnancy. This condition affects approximately 5-8% of pregnancies and can progress rapidly, potentially leading to life-threatening complications for both mother and baby if not properly managed. Preeclampsia is part of a spectrum of hypertensive disorders of pregnancy and can range from mild to severe, with severe preeclampsia requiring immediate intensive management and often urgent delivery.

The exact cause of preeclampsia remains unknown, but it's believed to involve problems with placental development and function, leading to widespread maternal vascular dysfunction. Risk factors include first pregnancy, previous history of preeclampsia, chronic hypertension, diabetes, kidney disease, autoimmune disorders, obesity, multiple gestation, maternal age over 35 or under 20, and family history of preeclampsia. African American women have a higher risk of developing severe preeclampsia, and certain genetic factors may also contribute to increased susceptibility.

Early signs and symptoms of preeclampsia include elevated blood pressure, protein in the urine, swelling (particularly of the face and hands), sudden weight gain, headaches, vision changes, upper abdominal pain, nausea and vomiting, and decreased urine output. Severe preeclampsia may present with very high blood pressure, severe headaches, vision problems, severe upper abdominal pain, decreased platelet count, elevated liver enzymes, and kidney dysfunction. Regular prenatal visits are crucial for early detection through blood pressure monitoring and urine testing.

Management of preeclampsia depends on the severity of the condition, gestational age, and maternal and fetal well-being. Mild preeclampsia may be managed with close monitoring, bed rest, and frequent medical evaluations, while severe preeclampsia typically requires hospitalization for intensive monitoring and immediate delivery consideration. Medications may be used to control blood pressure and prevent seizures (eclampsia), with magnesium sulfate being the standard treatment for seizure prevention. The only definitive treatment for preeclampsia is delivery of the baby and placenta, though the timing must be carefully balanced against the risks of prematurity. Our comprehensive approach includes close monitoring, patient education about warning signs, coordination with maternal-fetal medicine specialists when necessary, and immediate intervention when complications arise.