Key Points
- Stabilize ABCs; begin targeted evaluation without delaying life-saving therapy.
- Use system-specific risk tools to guide testing and disposition.
- Order high-yield tests first; escalate imaging when indicated.
- Start evidence-based initial therapy and reassess frequently.
Algorithm
- Primary survey and vitals; IV access and monitors.
- Focused history/physical; identify red flags and likely etiologies.
- Order system-appropriate labs and imaging (see Investigations).
- Initiate guideline-based empiric therapy (see Pharmacology).
- Reassess response; arrange consultation and definitive management.
Clinical Synopsis & Reasoning
For Preeclampsia Eclampsia Management, frame the differential by acuity and pathophysiology, then align diagnostics to the leading hypotheses. Prioritize stabilization while obtaining high‑yield studies such as CBC (Baseline hematology), BMP (Electrolytes/renal). Incorporate bedside imaging and targeted labs to define severity and identify complications; synthesize results with clinical trajectory to refine the working diagnosis and disposition needs.
Treatment Strategy & Disposition
Initiate disease‑directed therapy alongside supportive care, titrating to objective response. Pharmacologic options commonly include Analgesia/Antipyretics. Use validated frameworks (e.g., Antihypertensive Options (ED)) to guide escalation and site of care. Address precipitating factors, de‑escalate empiric therapies with data, and arrange follow‑up for monitoring and risk‑factor modification; admit patients with instability, high risk of deterioration, or needs for close monitoring.
Epidemiology / Risk Factors
- Risk factors vary by condition and patient profile
Investigations
| Test | Role / Rationale | Typical Findings | Notes |
|---|---|---|---|
| CBC | Baseline hematology | Abnormal counts | |
| BMP | Electrolytes/renal | Derangements |
Antihypertensive Options (ED)
| Drug | Dose (example) | Notes |
|---|---|---|
| Labetalol IV | 20 mg, then 40–80 mg q10 min (max 220 mg) | Avoid in asthma, bradycardia |
| Hydralazine IV | 5–10 mg q20–40 min | Headache/tachycardia |
| Nicardipine infusion | Start 5 mg/h, titrate | Arterial line preferred |
Pharmacology
| Medication | Mechanism | Onset | Role in Therapy | Limitations |
|---|---|---|---|---|
| Magnesium sulfate (IV) | NMDA antagonism; seizure prophylaxis | Minutes | Seizure prophylaxis/Tx | Respiratory depression; loss of reflexes; pregnancy/lactation considerations |
| Labetalol (IV) | α1/β blockade | Minutes | Severe HTN | Bradycardia; pregnancy/lactation considerations |
| Hydralazine (IV) | Arteriolar vasodilation | Minutes | Alternative HTN agent | Tachycardia; pregnancy/lactation considerations |
| Nifedipine (PO) | CCB | Hours | Transition oral control | Hypotension; pregnancy/lactation considerations |
Prognosis / Complications
- Prognosis depends on severity, comorbidities, and timeliness of care
Patient Education / Counseling
- Explain red flags and when to seek emergent care.
- Reinforce medication adherence and follow-up plan.
Notes
Give calcium gluconate 1 g IV for magnesium toxicity. Start seizure precautions and continuous BP/oximetry monitoring.