What monitoring is needed for women with preeclampsia following delivery?

Updated: Jun 12, 2018
  • Author: Michael P Carson, MD; Chief Editor: Edward H Springel, MD, FACOG  more...
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Answer

Answer

Women with preeclampsia require follow-up after hospital discharge to ensure normalization of blood pressure and any noted laboratory abnormalities. This follow-up may be undertaken via an internal medicine specialist (obstetric internist) and obstetrician or a family physician.

Hypertension due to preeclampsia may worsen or even present in the postpartum period. After delivery, women with preeclampsia require ongoing close blood pressure monitoring. Blood pressure sustained greater than 160/110 mm Hg should be urgently treated with IV antihypertensives. Oral antihypertensive therapy should be undertaken for sustained pressures above 155/105 mm Hg. As vasospasm resolves, these women may be weaned off their antihypertensive therapy.

Blood pressure changes due to preeclampsia usually resolve within days to weeks after delivery but may persist for 3 months. Persistent hypertension beyond this point probably represents chronic hypertension.

Laboratory abnormalities related to preeclampsia (eg, proteinuria, thrombocytopenia, liver enzyme elevations) should be followed until the abnormalities return to the reference range. Failure to normalize warrants an evaluation for other acute or chronic medical disorders with potential long-term consequences.

Preeclampsia and related disorders identify women at increase risk for future cardiovascular disease. [26] These women should be screened for cardiovascular risk factors, including cigarette smoking, glucose intolerance, low high-density lipoprotein cholesterol, elevated triglycerides, and obesity. The presence of any of these risk factors should be addressed with appropriate treatment and counseling regarding smoking cessation, diet, exercise, glucose control, weight loss, and appropriate medical treatment.


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