Preeclampsia

Preeclampsia is the triad of High blood pressure, protein in the urine, and swelling. Delivery of the baby will cure preeclampsia. Magnesium sulfate is often used to protect the woman from having a seizure.

Preeclampsia can be a very dangerous and scary disease. It is most common in first pregnancies and in the very young or very old. It is also more common with twins or higher multiples. If untreated, it can lead to seizures, stroke, bleeding problems, kidney failure, and liver problems. It is cured by delivery of the baby. If you develop preeclampsia near term, delivery will be necessary. If preeclampsia develops preterm, then it may be beneficial to try to get more time for the baby to develop. Bed rest can help delay the progression of preeclapsia. Steroid shots can be given to help the baby’s lungs mature more quickly.

Magnesium sulfate is a medication that is given through an IV and to help prevent seizures in women with preeclampsia. It has a narrow therapeutic window meaning the amount that is needed to help is close to the amount that is toxic. For this reason, blood levels are checked fairly often. Most women will need to be on bed rest while getting the magnesium sulfate. A catheter in the bladder is usually used.

HELLP syndrome is a severe type of preeclampsia. HELLP is an acronym that stands for hemolysis (breakdown of the blood cells), elevated liver enzymes, and low platelets. This can be extremely dangerous and is an indication for immediate delivery. It is common to monitor patients with preeclampsia with frequent blood tests to be sure that HELLP syndrome is not developing.

Delivery of the baby cures preeclampsia. It takes about 24 hours for the symptoms to clear. The blood pressure elevations may take longer to return to normal and may require treatment for several weeks. Magnesium sulfate and the urinary catheter are typically continued for 24 hours after delivery. Once the symptoms resolve, there should be no more danger for the mom or baby.

Rarely preeclampsia can come on in the postpartum period. This can develop up to 6 weeks after delivery. Postpartum preeclampsia is characterized by high blood pressure and protein in the urine. Treatment is bed rest and magnesium sulfate. It usually resolves on its own in a few days.

Watch for swelling in the feet and legs, headache that does not resolve with Tylenol, visual disturbances, and right upper abdominal pain. If these develop, you should contact your doctor right away.

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