Pre-eclampsia : Pregnancy after 20th week with hypertension , diastolic (≤90) two reading
in 4 hours apart and proteinuria .
Mild : 2 reading of diastolic BP 90-<110 4 hrs apart after 20 weeks of gestation with
protienuria more than 2+.
Severe pre –eclampsia : Diastolic BP(DBP) 110 or more after 20 wks of gestation with
protienuria more than 2.
Investigations :
• Urine for sugar and albumin
• Blood (hemoglobin, grouping & Rh and bed side clotting test)
One of the complication of PIH –is retardation of fetal growth and intra- uterine fetal death.
Edema, proteinuria and hypertension recover soon after delivery.
Treatment/Management :
• Mild pre – eclampsia
• If gestational week <37
• Bed rest in lateral position .
• Explain the warning sing of severe pre-eclampsia.
• Follow of in 1 weeks
• If gestational age >37 week consult with Doctor/refer
• Management of high BP :
• If DBP higher than 110, give Nifedipine 5mg orally (sub-lingual can cause acute fall in BP)
• Take BP 30 minutes after Nifedipine dose
• If DBP still higher than 110 repeat dose
• Repeat as necessary to keep DBP 90 - 100
Severe pre-eclampsia and eclampsia:
• Prevent eclampsia.
• Inform doctor immediately .
• Monitor vitals hourly .
• Admit to hospital
• Start I/V line of N S or RL
• Monitor urine output.
• Cap. Nifedepine 5mg squeezed orally (sub-lingual can cause acute fall in BP). If diastolic
BP is 110 or more and if respond to Nifedepine is inadequate, give additional 5 mg.
• Prevent seizures : Inj. Magnesium sulphate 4g IV stat with 12ml (20%) and 5 g in each
buttock as a deep IM injection with 1ml of 2% lignocaine. If convulsion occurs after 15
minutes give 2g 50% Magnesium sulphate IV over 5 minutes. Repeat every 4 hourly continue
treatment for 24 hours after delivery or last convulsion.
• Before giving next dose of magnesium sulphate watch for
- Respiratory rate → is at least 16/min
- Pateller reflexes are present
- Pateller relax → abscent
- Consult with doctor
- Deliver baby within 24 hrs of on set of symptoms in sever pre-eclampsia
- Delivery baby with in 12 hrs of onset of symptoms in eclamsia .
Note: Do not give Ergometrine to women with pre – eclampsia, eclampsia or high Blood preeclampsia,
eclampsia or high blood pressure because it increases risk of convulsion and cerebral
vascular accident.
Source :STANDARD TREATMENT PROTOCOL FOR HEALTH POSTS AND SUB HEALTH POSTS 2070
in 4 hours apart and proteinuria .
Mild : 2 reading of diastolic BP 90-<110 4 hrs apart after 20 weeks of gestation with
protienuria more than 2+.
Severe pre –eclampsia : Diastolic BP(DBP) 110 or more after 20 wks of gestation with
protienuria more than 2.
Investigations :
• Urine for sugar and albumin
• Blood (hemoglobin, grouping & Rh and bed side clotting test)
One of the complication of PIH –is retardation of fetal growth and intra- uterine fetal death.
Edema, proteinuria and hypertension recover soon after delivery.
Treatment/Management :
• Mild pre – eclampsia
• If gestational week <37
• Bed rest in lateral position .
• Explain the warning sing of severe pre-eclampsia.
• Follow of in 1 weeks
• If gestational age >37 week consult with Doctor/refer
• Management of high BP :
• If DBP higher than 110, give Nifedipine 5mg orally (sub-lingual can cause acute fall in BP)
• Take BP 30 minutes after Nifedipine dose
• If DBP still higher than 110 repeat dose
• Repeat as necessary to keep DBP 90 - 100
Severe pre-eclampsia and eclampsia:
• Prevent eclampsia.
• Inform doctor immediately .
• Monitor vitals hourly .
• Admit to hospital
• Start I/V line of N S or RL
• Monitor urine output.
• Cap. Nifedepine 5mg squeezed orally (sub-lingual can cause acute fall in BP). If diastolic
BP is 110 or more and if respond to Nifedepine is inadequate, give additional 5 mg.
• Prevent seizures : Inj. Magnesium sulphate 4g IV stat with 12ml (20%) and 5 g in each
buttock as a deep IM injection with 1ml of 2% lignocaine. If convulsion occurs after 15
minutes give 2g 50% Magnesium sulphate IV over 5 minutes. Repeat every 4 hourly continue
treatment for 24 hours after delivery or last convulsion.
• Before giving next dose of magnesium sulphate watch for
- Respiratory rate → is at least 16/min
- Pateller reflexes are present
- Pateller relax → abscent
- Consult with doctor
- Deliver baby within 24 hrs of on set of symptoms in sever pre-eclampsia
- Delivery baby with in 12 hrs of onset of symptoms in eclamsia .
Note: Do not give Ergometrine to women with pre – eclampsia, eclampsia or high Blood preeclampsia,
eclampsia or high blood pressure because it increases risk of convulsion and cerebral
vascular accident.
Source :STANDARD TREATMENT PROTOCOL FOR HEALTH POSTS AND SUB HEALTH POSTS 2070
