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Diagnosing preeclampsia may be accomplished by noting painless swelling of the arms, legs, and/or face, in addition to abnormal weight gain. The patient's blood pressure is taken during every doctor's visit during pregnancy. An increase of 30 mm Hg in the systolic pressure, or 15 mm Hg in the diastolic pressure, or a blood pressure reading greater than 140/90 mm Hg is considered indicative of preeclampsia. A simple laboratory test in the doctor's office can indicate the presence of protein in a urine sample (a dipstick test). A more exact measurement of the amount of protein in the urine can be obtained by collecting urine for 24 hours, and then testing it in a laboratory to determine the actual quantity of protein present. A 24-hour urine specimen containing more than 500 mg of protein is considered indicative of preeclampsia.
With mild preeclampsia, treatment may be limited to bed rest, with careful daily monitoring of weight, blood pressure, and urine protein via dipstick. This careful monitoring will be required throughout pregnancy, labor, delivery, and even for 2–4 days after the baby has been born. About 25% of all cases of eclampsia develop in the first few days after the baby's birth. If the diastolic pressure does not rise over 100 mm Hg prior to delivery, and no other symptoms develop, the woman can continue pregnancy until the fetus is mature enough to be delivered safely. Ultrasound tests can be performed to monitor the health and development of the fetus.
If the diastolic blood pressure continues to rise over 100 mm Hg, or if other symptoms like headache, vision problems, abdominal pain, or blood abnormalities develop, then the patient may require medications to prevent seizures. Magnesium sulfate is commonly given through a needle in a vein (intravenous, or IV). Medications that lower blood pressure (antihypertensive drugs) are reserved for patients with very high diastolic pressures (over 110 mm Hg), because lowering the blood pressure will decrease the amount of blood reaching the fetus. This places the fetus at risk for oxygen deprivation. If preeclampsia appears to be progressing toward true eclampsia, then medications may be given in order to start labor. Babies can usually be delivered vaginally. After the baby is delivered, the woman's blood pressure and other vital signs will usually begin to return to normal quickly.
Author Info: Rosalyn Carson-DeWitt MD, The Gale Group Inc., Gale, Detroit, Gale Encyclopedia of Medicine, 2002This feature is for informational purposes only and should not be used to replace the care and information received from your healthcare provider. Please consult a healthcare professional with any health concerns you may have.
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