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In general, the treatment of postpartum preeclampsia is the same as during pregnancy, including using anti-hypertensive medications to lower blood pressure and magnesium sulfate to prevent eclampsia. The same blood pressure medications that are used during pregnancy can be used in the postpartum period.
Eclampsia, like pre-eclampsia, tends to occur more commonly in first pregnancies than subsequent pregnancies. [38] [39] [40] Women who have long term high blood pressure before becoming pregnant have a greater risk of pre-eclampsia. [38] [39] Patients who have gestational hypertension and pre-eclampsia have an increased risk of eclampsia. [41]
Hypertensive disorders during pregnancy, such as gestational hypertension, preeclampsia, and eclampsia, are a major contributor to maternal and fetal illness and death on a worldwide scale. Around 5-10% of pregnancies are affected by these conditions, with preeclampsia being responsible for up to 14% of maternal deaths globally.
Potential severe hypertensive states of pregnancy are mainly: Pre-eclampsia – gestational hypertension, proteinuria (>300 mg), and edema. Severe pre-eclampsia involves a BP over 160/110 (with additional signs). It affects 5–8% of pregnancies. [20] Eclampsia – seizures in a pre-eclamptic patient, affect around 1.4% of pregnancies. [21]
Hypertensive disorders including preeclampsia, especially in women over 40 Even if you don’t have any of the aforementioned health conditions, age can also play a factor into your pregnancy.
Pregnant woman has severe pregnancy-induced hypertension, [49] severe eclampsia [49] /preeclampsia, [41] active vaginal bleeding, [49] placental abruption, a cardiac disease, [49] or another condition which indicates that the pregnancy should not continue. [49] Maternal hemodynamic instability with bleeding [41]
This is particularly true if the pregnancy is beyond 34 weeks of gestation. [2] Medications may be used to decrease blood pressure and blood transfusions may be required. [1] HELLP syndrome occurs in about 0.7% of pregnancies and affects about 15% of women with eclampsia or severe pre-eclampsia. [5] [2] Death of the mother is uncommon (< 1%).
In pregnant women, preeclampsia may occur after 20 weeks of pregnancy, often in women who have no history of high blood pressure. Symptoms of preeclampsia may include severe headache, vision changes and pain under the ribs. [45] However, in some women, symptoms may not occur, until they go for a routine prenatal visit. [46]