Hypertension and Pregnancy

Got a hypertensive pregnant patient? 

Preelampsia:  Hypertension >140/90 with proteinuria >300mg/24hours

Eclampsia:  Addition of SZ activitity, signs of end organ involvement (i.e. visual complaints and headache, creatinine elevation)

Watch out for HELLP!  Hemolysis, elevated liver enzyme, low platelets

Treatment:  Expectant management, delivery if possible, treat seizures with Magnesium Dose:  6g loading followed by 2g/hour

Learning point from recent patient:  Preeclampsia can occur up to 6 weeks post-partum, IV or oral labetolol and oral nifedipine and labetolol are safe medications to control hypertension in pregnant and post-partum females (including breastfeeding mom’s).