Preeclampsia (Critical Diagnosis)

Never ignore a pregnant woman’s blood pressure.











Introduction











* Pre-Eclampsia* Pathophysiology unknown* Pregnancy induced multi-organ dysfunction* Definition* Pregnancy* PLUS* BP 135/85* PLUS* Proteinuria* Eclampsia* Preeclampsia* PLUS* Seizures* HELLP Syndrome* Preeclampsia* PLUS* Hemolysis* PLUS* Elevated liver enzymes* PLUS* Low platelets











Step 1: Evaluate For Four Big Symptoms











* Swelling/edema* Headache* Visual changes* Abdominal pain











Step 2: Testing











* Urinalysis* Proteinuria* CBC* Hemolysis* Thrombocytopenia* Electrolytes* Liver function tests











Step 3: Start Magnesium











* Hypomagnesemia = Hyporeflexia











Step 4: Control the Blood Pressure











* Hydralazine* Labetalol











Step 5: Admit











* OB emergency* All patients need fetal monitoring











Additional Reading











* Round 2 – Seizure (EM Clerkship)* Preeclampsia and High Blood Pressure During Pregnancy (ACOG)