The mildest form of hypertension in a pregnant patient without proteinuria, edema or evidence of end-organ damage may be managed on an outpatient basis, as this does not meet the diagnostic criteria for true preeclampsia. Prior to discharge, one must discuss the case in detail with the patient's obstetrician and ensure strict reassessment within 48 hours. Each patient must be counseled regarding reasons for immediate return to the hospital. Hypertension and proteinuria constitute preeclampsia. These patients should be admitted to the hospital for an immediate obstetrical evaluation.
Severe preeclampsia is managed in an intensive care setting as if the patient was truly eclamptic.
Magnesium sulfate is given for seizure prophylaxis and hydralazine or certain other antihypertensive drugs are given for blood pressure control. Care is taken not to drop the blood pressure too drastically, causing inadequate uteroplacental perfusion and fetal distress. Maintaining a diastolic blood pressure of 90 mm Hg is the goal of antihypertensive therapy. If the gestational age is greater than 30 weeks, delivery is indicated. All forms of preeclampsia warrant immediate obstetrical consultation.