Hypertensive Emergencies of Pregnancy

PreEclampsia, Eclampsia, HELLP syndrome

Diagnosis: BP >140/90 plus end organ dysfunction

  • Acute Kidney Injury
  • Proteinuria
  • Thrombocytopenia
  • Transaminitis
  • Hemolysis
  • Pulmonary Edema
  • Cerebral Edema / Hemorrhage
  • Headache refractory to tylenol
  • Visual Changes
  • RUQ Pain not attributable to another diagnosis

Treatment

  • Loading Dose: IV Magnesium 4-6g over 20-30 min OR 5g IM in each buttock
  • Maintenance Dose: 1g/hr IV
  • Antihypertensives (goal 20% reduction): Labetalol, Nicardipine, Hydralazine
  • Delivery of fetus and placenta