Preeclampsia: Treatment Preeclampsia resolves within a few weeks after delivery. For pregnant women with preeclampsia prior to 37 weeks' gestation, delivery reduces the mother's morbidity but exposes the fetus to the risk of premature delivery. The management of preeclampsia is challenging because it requires the clinician to balance the health of both mother and fetus simultaneously and to make management decisions that afford both the best opportunities for infant survival. In general, prior to term, women with mild preeclampsia can be managed conservatively with bed rest, close monitoring of blood pressure and renal function, and careful fetal surveillance. For. | Chapter 007. Medical Disorders during Pregnancy Part 2 Preeclampsia Treatment Preeclampsia resolves within a few weeks after delivery. For pregnant women with preeclampsia prior to 37 weeks gestation delivery reduces the mother s morbidity but exposes the fetus to the risk of premature delivery. The management of preeclampsia is challenging because it requires the clinician to balance the health of both mother and fetus simultaneously and to make management decisions that afford both the best opportunities for infant survival. In general prior to term women with mild preeclampsia can be managed conservatively with bed rest close monitoring of blood pressure and renal function and careful fetal surveillance. For women with severe preeclampsia delivery is recommended unless the patient is eligible for expectant management in a tertiary hospital setting. Expectant management of severe preeclampsia remote from term affords some benefits for the fetus with significant risks for the mother. The definitive treatment of preeclampsia is delivery of the fetus and placenta. For women with severe preeclampsia aggressive management of blood pressures 160 110 mmHg reduces the risk of cerebrovascular accidents. Intravenous labetalol or hydralazine are the drugs most commonly used to manage preeclampsia. Intravenous hydralazine may be associated with more episodes of maternal hypotension than labetalol. Alternative agents such as calcium channel blockers may be used. Elevated arterial pressure should be reduced slowly to avoid hypotension and a decrease in blood flow to the fetus. Angiotensinconverting enzyme ACE inhibitors as well as angiotensin-receptor blockers should be avoided in the second and third trimesters ofpregnancy because of their adverse effects on fetal development. Pregnant women treated with ACE inhibitors often develop oligohydramnios which may be caused by decreased fetal renal function. Magnesium sulfate is the treatment of choice for the prevention and .
