Management Plan for Patients with Preeclampsia with Severe Features - Flowchart
Management Plan for Patients with Preeclampsia with Severe Features - Flowchart Preeclampsia Preeclampsia
«Flowchart»


Admit to labor and delivery, observe for 24–48 hours
Corticosteroids, magnesium sulfate prophylaxis
Antihypertensives for severe blood pressure
Ultrasound, fetal heart rate monitoring
Monitor symptoms and laboratory tests


Admit to labor and delivery, observe for 24–48 hours
Corticosteroids, magnesium sulfate prophylaxis
Antihypertensives for severe blood pressure
Ultrasound, fetal heart rate monitoring
Monitor symptoms and laboratory tests


Admit to labor and delivery, observe for 24–48 hours
Corticosteroids, magnesium sulfate prophylaxis
Antihypertensives for severe blood pressure
Ultrasound, fetal heart rate monitoring
Monitor symptoms and laboratory tests


Admit to labor and delivery, observe for 24–48 hours
Corticosteroids, magnesium sulfate prophylaxis
Antihypertensives for severe blood pressure
Ultrasound, fetal heart rate monitoring
Monitor symptoms and laboratory tests

Offer continued expectant management


Inpatient only, discontinue magnesium sulfate after 12–24 hours
Daily maternal-fetal testing, symptoms, blood pressure, lab tests

Offer continued expectant management


Inpatient only, discontinue magnesium sulfate after 12–24 hours
Daily maternal-fetal testing, symptoms, blood pressure, lab tests

Offer continued expectant management

Offer continued expectant management


Inpatient only, discontinue magnesium sulfate after 12–24 hours
Daily maternal-fetal testing, symptoms, blood pressure, lab tests


Inpatient only, discontinue magnesium sulfate after 12–24 hours
Daily maternal-fetal testing, symptoms, blood pressure, lab tests

Delivery

Delivery

Delivery

End

End

End

Deliver after 48 hr

Deliver after 48 hr

Deliver after 48 hr

24–32 weeks expectant management
Deliver at 340/7weeks

24–32 weeks expectant management
Deliver at 340/7weeks

24–32 weeks expectant management
Deliver at 340/7weeks


0/7

Contraindications to continued expectant management?


Eclampsia
<230/7 weeks
Pulmonary edema
Abnormal fetal testing
Acute renal failure, disseminated intravascular coagulopathy
Abruptio placentae

Contraindications to continued expectant management?


Eclampsia
<230/7 weeks
Pulmonary edema
Abnormal fetal testing
Acute renal failure, disseminated intravascular coagulopathy
Abruptio placentae

Contraindications to continued expectant management?

Contraindications to continued expectant management?


Eclampsia
<230/7 weeks
Pulmonary edema
Abnormal fetal testing
Acute renal failure, disseminated intravascular coagulopathy
Abruptio placentae


Eclampsia
<230/7 weeks 0/7
Pulmonary edema
Abnormal fetal testing
Acute renal failure, disseminated intravascular coagulopathy
Abruptio placentae

Yes

Yes

Yes

No

No

No

Are there additional complications?


Persistent symptoms
HELLP/partial HELLP syndrome
Fetal weight less than fifth percentile + oligohydramnios or umbilical artery REDF
Labor/rupture of membrane 330/7–335/7 weeks

Are there additional complications?


Persistent symptoms
HELLP/partial HELLP syndrome
Fetal weight less than fifth percentile + oligohydramnios or umbilical artery REDF
Labor/rupture of membrane 330/7–335/7 weeks

Are there additional complications?

Are there additional complications?


Persistent symptoms
HELLP/partial HELLP syndrome
Fetal weight less than fifth percentile + oligohydramnios or umbilical artery REDF
Labor/rupture of membrane 330/7–335/7 weeks


Persistent symptoms
HELLP/partial HELLP syndrome
Fetal weight less than fifth percentile + oligohydramnios or umbilical artery REDF
Labor/rupture of membrane 330/7–335/7 weeks 0/7 5/7

Yes

Yes

Yes

No

No

No