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| |    Treatment of Pre-Eclampsia by Elisa Ross, MD reviewed and revised by Marjorie Greenfield, M.D. The only treatment for pre-eclampsia is delivery If you have pre-eclampsia and you are near your due date, you should discuss with your practitioner the pros and cons of delivering early. In many cases, labor can be induced. Having a regular vaginal birth is preferable if you and the baby are stable, and your pre-eclampsia is not too severe. Cesarean delivery is recommended in instances where the pre-eclampsia is progressing rapidly, there is concern for the baby's well-being, or if you had been planning a cesarean birth for other reasons. If pre-eclampsia is diagnosed and your baby is not near its due date, you may be asked to rest as much as possible on your left side, and return for office visits more frequently. Sometimes hospital admission is required to monitor the mother and baby while trying to buy time before delivery is necessary. In rare cases, pre-eclampsia may become severe enough that delivery of a premature baby is the only option. While this is a serious step to take, it is only made in instances where a mother's life is at stake (and therefore, her baby's as well). Labor for women with pre-eclampsia During labor, women with pre-eclampsia must stay lying down, and are usually monitored closely. A foley catheter will probably be placed into the bladder to accurately measure urine output, and to avoid having the woman get up to urinate. Continuous fetal monitoring is used to be sure that the baby is tolerating the contractions. Magnesium or other medications might be given during labor Some women require medications to control their blood pressure. While this does not stop the basic process of pre-eclampsia, it does protect against stroke. In many situations, a medication called magnesium sulfate is given through an IV to decrease the mother's risk of seizures. It is generally given continuously until 12 to 24 hours after childbirth. If your practitioner advises magnesium, it is because the perceived benefit of preventing seizures, as rare as they may be, outweighs the small risks of the magnesium in his or her assessment. Side effects of magnesium Magnesium sulfate has few known true adverse effects on mother or baby, especially if given in the proper dose. Side effects that do not jeopardize health usually occur, however. The mother may feel flushed while the first dose is being given. She also may feel lethargic while the infusion is continuing. Some babies appear slightly lethargic at birth as well. Some studies have found that magnesium may impart a protective benefit to the baby's brain. The magnesium leaves the body through the urine, with magnesium levels returning to normal within a few hours after the treatment is stopped. Pre-eclampsia usually goes away soon after delivery It may take days or weeks after delivery for blood pressure to return to normal, but it often shows marked improvement while the mother is still in the hospital. Likelihood of pre-eclampsia in future pregnancies In women who developed mild pre-eclampsia late in a prior pregnancy, the chance of recurrence is five to seven percent, compared to the one percent risk for women who had no blood pressure problem in the preceding pregnancy. If the pre-eclampsia was severe or occurred early in pregnancy, the chances of recurrence may be substantially greater.
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