PRE-ECLAMPSIA.

Two important clinical categories of pre-eclampsia are defined:

(A) Mild Pre-eclampsia: the only pertinent physical findings are BP<160/110>(B) Severe Pre-eclampsia: A more severe form in which BP equals or exceeds 160/110 mmHg. Symptoms of severity are usually present e.g. headaches, blurred vision, abdominal pain and marked LL edema. In severe cases HELLP syndrome may be seen (hemolysis, elevated liver enzymes, low platelets). Renal impairment also maybe present. Before anything to do, try to stabilize the patient with bed-rest and IV antihypertensive drugs (hydralazine), If the patient responded well and the blood pressure goes down, do the same as for mild pre-eclampsia. If not, prompt vaginal delivery is a must unless CS is indicated for other causes.

As regard MgSO4, in the mild form: it's given only intrapartum and for 24 hrs after delivery. In the severe form: it's given from the moment of admission till 24 hrs after delivery.

As regard the mode of delivery in patients with mild or severe pre-eclampsia, vaginal delivery is the role unless C.section is obstetrically indicated.