Seizure prophylaxis, blood pressure control and induction in pre-eclampsia
THE CONTEXT
Management of severe pre-eclampsia includes seizure prophylaxis, prevention of maternal cardiovascular complications and induction appropriate to cervical ripeness.
Seizure prophylaxis and antihypertensive therapy
•
Magnesium sulfate is recommended antepartum, intrapartum and postpartum for seizure prophylaxis in women with pre-eclampsia with severe features or imminent eclampsia.
•
Antihypertensive therapy is indicated to prevent maternal cardiovascular complications. Listed options are intravenous labetalol, intravenous hydralazine and oral nifedipine.
•
Antihypertensive drugs should be used during induction in severe pre-eclampsia.
Induction according to cervical ripeness
•
With a ripe cervix, surgical induction by low rupture of the membranes is the method of choice; oxytocin infusion may be added.
•
With an unripe cervix, prostaglandin E2 gel is used for cervical ripening, after which low rupture of the membranes can be performed.