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)