Treatment of high blood pressure in Pregnancy Preeclampsia Treatment

The only definitive "treatment" for preeclampsia (Pregnancy induced hypertension) is delivery the fetus, either vaginal or cesarean (c-section). Inducing labor is the treatment of choice for women who have reached a gestational age of at least 37 weeks. In all cases, the consensus is that all women with preeclampsia (Pregnancy induced hypertension) should be delivered by 40 weeks, and the use of induction drugs and cervical ripening agents is common.

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The goal of treatment is to prevent the condition from becoming worse and to prevent it from causing other complications.

For women who have not reached 37 weeks, treatment focuses on allowing the baby to mature as much as possible before inducing labor. The goal of preeclampsia (Pregnancy induced hypertension) treatment is to avoid progression of the disease and/or complications. A number of studies have shown that close outpatient monitoring is as effective as hospitalization for the majority of women, though women with severe disease usually require careful monitoring that is best accomplished in a hospital setting. In general, outpatient preeclampsia (Pregnancy induced hypertension) treatment means:

Visiting the doctor every one to three days for a checkup 
Having weekly or twice weekly lab tests to check liver enzymes and kidney function 
Limiting difficult physical activity 
High blood pressure medications are generally not given to women who are being treated on an outpatient basis, though certain medications are sometimes used during hospital-based treatment for severe preeclampsia (Pregnancy induced hypertension). Similarly, there is currently no indication for either restricting salt intake or using diuretics in cases of preelampsia (Pregnancy induced hypertension) though both of these are commonly used for the initial treatment of high blood pressure not related to pregnancy. Bed rest is a well-known treatment measure, but, like salt restriction and diuretics, it has not been proven to improve ultimate outcomes.

The guiding factor in the treatment of preeclampsia (Pregnancy induced hypertension) is the health of the mother and the baby. In situations where the health of the mother or the baby appears to be in jeopardy, labor is usually induced. Specifically, signs that indicate labor induction should be started include:

Persistent headaches or vision disturbances (blurry vision) 
Persistent abdominal pain 
Signs of severe fetal growth delay/restriction 
Signs of impaired fetal well-being 
Maternal platelet count less than 100,000 
Worsening maternal liver function as observed on blood tests 
Worsening maternal kidney function as observed on blood tests (Creatinine >2) 
When delivery must be induced at a gestational age of less than 34 weeks, a course of steroids (usually betamethasone or dexamethasone) is given. This is done to help the baby's lungs develop, since babies born before 34 weeks almost always have some difficulty breathing because their lungs are still immature.

In cases of mild to severe preelampsia (Pregnancy induced hypertension) magnesium is usually given intravenously to prevent seizures and other serious potential complications to prevent eclampsia . Numerous studies have shown that magnesium is vastly superior to other drugs for this purpose.

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