California Maternal Quality Care Collaborative calls preeclampsia hypertension in pregnant women and eclampsia hypertension with seizures in pregnant women. The criteria for preeclampsia are the following: blood pressure greater than or equal to 140/90 on two occasions at least four hours apart after 20 weeks gestation in a woman with previously normal blood pressure, proteinuria greater than or equal to 300mg per 24-hour urine collection, protein/creatinine ratio greater than or equal to 0.3, thrombocytopenia with a platelet count less than 100,000 microliters, renal insufficiency, impaired liver function, pulmonary edema, and cerebral or visual symptoms.
California Maternal Quality Care Collaborative (CMQCC) discussed the acronym HELLP, …show more content…
If a pregnant woman presents with new-onset of hypertension or new-onset of proteinuria, as well as complaints of a headache, abdominal or chest pain, shortness of breath, generalized swelling, or “not feeling right” they should be evaluated for preeclampsia. Labs to be done in order for preeclampsia to be diagnosed or ruled out are: CBC with platelet count, AST, ALT, LDH, creatinine, bilirubin, uric acid, glucose, serum amylase, lipase, and ammonia. For the treatment of preeclampsia, if the patient’s blood pressure is greater than or equal to 160/110 treatment needs to occur within 30-60 minutes with antihypertensive, as a blood pressure this high can lead to stroke and death. The antihypertensives that should be given are Labetalol (IV push over 2 minutes) according to the protocol with a blood pressure recheck in between all doses given, if Labetalol does not work switch to Hydralazine (IV push over 2 minutes) according to the protocol, with a target blood pressure 140-150/90-100. For patients presenting with a new-onset under 34 weeks gestation they are to be admitted for a minimum of 24 hours of observation for the prevention of maternal morbidity and mortality. During this time they will be given corticosteroids, 24-hour urine collection, blood pressure monitoring, labs, and must be evaluated by and