Preeclampsia Management Overview
This content covers the management of preeclampsia, focusing on inpatient and outpatient care strategies, considerations for different gestational ages, antihypertensive management, and post-delivery monitoring. It discusses the roles of inpatient care for severe cases and outpatient care for stable patients, along with treatment protocols and follow-up procedures.
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Presentation Transcript
INPATIENT VS OUTPATIENT INPATIENT VS OUTPATIENT MANAGEMENT OF PREECLAMPSIA MANAGEMENT OF PREECLAMPSIA Donna D. Johnson, MD
INPATIENT FOR DELIVERY INPATIENT FOR DELIVERY > 37 0/7 weeks for PE with or without severe features > 34 0/7 weeks for PE with severe features
INPATIENT MANAGEMENT INPATIENT MANAGEMENT Severe preeclampsia Regardless of the gestational age Unreliable patient Transportation issues
INPATIENT MANAGEMENT CONSIDERATIONS INPATIENT MANAGEMENT CONSIDERATIONS < 34 0/7 weeks with PE without severe features Increased risk for severe PE Diabetes Hypertension Renal disease CV disease Twins Failed outpatient management
CONSIDERING OUTPATIENT MANAGEMENT CONSIDERING OUTPATIENT MANAGEMENT Reliable patient Assess fetal well being Ultrasound for growth Labs: CBC with platelets, CMP
OUTPATIENT MANAGEMENT OUTPATIENT MANAGEMENT 34 0/7 weeks to 37 0/7 weeks: PE without severe features 34 0/7 weeks to 37 0/7 weeks: Gestational hypertension < 34 0/7 weeks in uncomplicated PE without severe features
OUTPATIENT MANAGEMENT OUTPATIENT MANAGEMENT 1-2 times a week clinic visit Once a week labs Home blood pressure monitoring Excellent education on signs and symptoms to return Fetal assessment as indicated Use the right sized BP cuff
ANTIHYPERTENSIVE MANAGEMENT ANTIHYPERTENSIVE MANAGEMENT If hypertensive on medication, increase medication If not hypertensive, consider starting medication
AFTER DELIVERY AFTER DELIVERY Treat aggressively BP increases at home If hypertensive, see in one week Consider home blood pressure monitoring
