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)