Pre-eclampsia medical therapy

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sara Zand, M.D.[2] Ogheneochuko Ajari, MB.BS, MS [3]

Overview

• The aim of therapy is starting treatment in blood pressure≥ 140/90 mmHg in office or clinic and blood pressure ≥ 135/85 mmHg at home and reaching the target systolic blood pressure 110-140 mmHg and diastolic blood pressure less than 85 mmHg regardless the type of hypertension in pregnancy.

Treatment

Medical Therapy

• The mainstay of therapy for hypertension in preeclampsia is oral methyldopa, labetalol, oxprenolol, and nifedipine, and second or third line agents include hydralazine and prazosin.
• The mainstay of therapy for preeclampsia, who have proteinuria with severe hypertension or hypertension with neurologic signs and symptoms, is magnesium sulfate (MgSO4) for convulsion prophylaxis.
• Urgent therapy for severe hypertension( blood pressure >160/110) is oral nifedipine or intravenous labetalol or hydralazine or oral labetalol.

Serum Magnesium Concentration (mg/dL) !! Effect
5–9	Therapeutic range
>9	Loss of patellar reflexes
> 12	Respiratory paralysis
> 30	Cardiac arrest