Assessment

Assessment of severe pre-eclampsia comprises:

• Admit to hospital
• Blood tests if available (FBC/U&E/LFT/Coag)
• Treatment and monitoring of hypertension

BP management

Blood pressure management comprises:

• Measure blood pressure hourly or more if clinical need requires
• Labetolol as first-line treatment
• Maintain diastolic BP 80-100 and systolic BP <150
• Alternative BP control can be with nifedipine, hydralazine or methyldopa
• Consider MgS04 loading and infusion (4 g then 1 g/hr for 24 hours)

Close attention to fluid status

Pay particular attention to:

• Maintaining euvolaemia
• Avoiding excessive fluid administration
• Restricting to 85 ml/hr including intravenous and oral fluids
• If oliguric <0.5 ml/kg/hr cautious fluid bolus
• Consider diuretic if hypervolaemic but still oliguric