Obstetrics Manual for Merrygold Hospitals - State Innovations in ...

2.6.4 Protocol for Management of Pre-eclampsia and Eclampsia
Management of Pre-eclampsia & Eclampsia
2.6.4.1 At-risk groups
BP : 130/84 at least on 2 occasions in a week’s apart
Family h/o : High BP, Pre-eclampsia
Past h/o : Eclampsia, pre-eclampsia, Chronic Hypertension, renal disease,
diabetes, thrombopaenia
Specific h/o : Obesity, extremes of maternal age, twin gestation, gestational diabetes
2.6.4.2 Definition:
BP: 140/90 mm Hg or more on 2 occasions recorded 6 hrs apart with proteinuria
Mild: Diastolic BP: 90 to 110 mm Hg without any complication (no Signs and
symptoms, Mild proteinuria upto 2+)
Severe:
a BP > 160/110 mm Hg (either systolic or diastolic or both) with proteinuria > 3+
without any other complication
b BP < 160/ 110 mm Hg with any of the following:
• Headache,
• Visual symptom, blurred vision,
• Oliguria,
• Low platelets (less than 100,000)
• High serum creatinine,
• High serum uric acid,
• Epigastric pain, or vomiting
• IUGR without any other complication,
• Elevated liver enzymes- ALT or AST >70 iu/litre
• Pulmonary edema
• Papilloedema
2.6.4.3 Management
Antenatal Management of Mild Type (pre-eclampsia):
If BP stays at >140/90 but < than 160/110, with mild proteinuria, then advice for:
• Full Investigation: renal, hepatic, haematology.
• Frequent visits
• Start anti-HT drugs if DBP > 100; preferably alpha methyldopa or nifedipine
• Hospitalise if severity increases
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