Hypertension in pregnancy - Management of severe preeclampsia

In case of severe preeclampsia:
• Around 25-33wks - expectant management with intensive maternal & fetal surveillance.
Deliver if maternal or fetal indication is there.
•At >/3 4wks - stabilize the pt with strict fetal surveillance & deliver.

 The only definitive treatment of preeclampsia is termination of pregnancy.
The preferred mode of delivery is vaginal.
Adequate pain relief should be provided during labour to cut down the catecholamine release & hypertensive response to labour pains.
Epidural analgesia is preferred as it helps to control the BP, improves uteroplacental circulation & it is highly effective.
Ergometrine is not recommended to prevent PPH due to its intense vasoconstrictive effect.
Oxytocin infusion can be used.

 Caesarean section may become necessary:
-If vaginal delivery not achieved even 24hrs after induction.
-Remote from term.
-In case of imminent eclampsia.

 Regional anaesthesia is safer as it avoids risks like aspiration & other anesthesia related complications.


-Hypertension in pregnancy-classification
-Hypertension in pregnancy-gestational hypertension
-Preeclampsia
-Eclampsia, preeclamsia superimposed on chronic hypertension
-Chronic hypertension
-Hypertension in pregnancy-etiology and pathogenesis
-Pathology
-Mild hypertension in pregnancy-prevention and management
-Severe hypertension in pregnancy-management
-Severe preeclampsia in pregnancy-management
-Complications of hypertension
-Antihypertensive therapy- centrally acting drugs
-Antihypertensive therapy-beta blockers, calcium channel blockers
-Antihypertensive therapy-alpha blockers, vasodilator, diuretics, ACE inhibitors
-Acute severe hypertension - treatment
-Eclampsia - signs and symptoms
-Eclampsia - management