Blood Pressure Measurement

A blood pressure reading of 140/90 or higher is considered too high whether or not a woman is pregnant. During pregnancy, blood pressure in the third trimester is compared with blood pressure before pregnancy or during the beginning of the second trimester. Blood pressure is elevated during pregnancy if:

• The first number in your blood pressure reading has risen 30 mmHg or more, or
• The second number has risen 15 mmHg or more

Fluid Retention Assessment

Sometimes, fluid retention is obvious during the physical exam. Fluid retention may cause weight gain of more than five pounds in one week. Sudden weight gain over one or two days is almost certainly due to fluid retention.

Urine Test

Under normal circumstances, there is no or minimal measurable protein in urine. In pre-eclampsia, significant amounts of protein usually appear in the urine.

Blood Tests

Blood tests include checking:

• Complete blood count
• Clotting factors
• Electrolytes
• Kidney and liver function

Early Delivery of the Baby

If the pregnancy has progressed 36 weeks or more, your doctor may recommend that labor be induced.

Supplements and Medication

Mild pre-eclampsia can often be managed with rest and medicine until 36 weeks gestation. For example, your doctor may recommend that you take:

• Medicines to lower blood pressure
• Magnesium sulfate to reduce the risk of convulsions
• Daily calcium supplement—may reduce the risk of eclampsia, particularly if your calcium intake was low before pregnancy

Home Treatment

If your home situation is stable and you live close to the hospital, your doctor may recommend that you rest at home in a quiet environment. Home treatment may include:

• Taking frequent blood pressure readings
• Getting plenty of rest, mostly in bed
• Obtaining help to prepare meals, do housework, and care for family members

Admission to the Hospital

If pre-eclampsia is moderate or your home situation is not restful, the doctor may admit you to the hospital. Treatment may include:

• Lowering your blood pressure with medication
• Medicines to prevent eclampsia
• Monitoring your baby's condition
• Making sure you get enough rest

Severe Pre-eclampsia

If the pre-eclampsia is severe, labor may be induced as early as 28 weeks. Early delivery poses a risk to the fetus, but allowing severe pre-eclampsia to continue is extremely risky for the mother and fetus. If possible, the doctor will delay delivery up to 48 hours so that the mother can take medicines to help the baby's lungs mature.

Most women with pre-eclampsia still deliver healthy babies. A few develop eclampsia, in which seizures, caused by severe pre-eclampsia, occur. Fortunately, pre-eclampsia is usually detected early in women who get regular prenatal care, and most seizures can be prevented.