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Treatments and drugs
By Mayo Clinic staffThe only cure for preeclampsia is delivery. You're at increased risk of seizures, placental abruption, stroke and possibly severe bleeding until your blood pressure decreases. Of course, if it's too early in your pregnancy, delivery may not be the best thing for your baby.
If you've had preeclampsia in one or more previous pregnancies, some experts recommend more frequent prenatal visits than normally recommended for pregnancy. Your doctor may ask you to come in every two weeks between the 20th and 32nd week of your gestation, and weekly after that until delivery.
Medications
Your doctor may recommend the following:
- Medications to lower blood pressure. These medications, called antihypertensives, are used to lower your blood pressure until delivery.
- Corticosteroids. If you have severe preeclampsia or HELLP syndrome, corticosteroid medications can temporarily improve liver and platelet functioning to help prolong your pregnancy. Corticosteroids can also help your baby's lungs become more mature in as little as 48 hours — an important step in helping a premature baby prepare for life outside the womb.
- Anticonvulsive medications. If your preeclampsia is severe, your doctor may prescribe an anticonvulsive medication, such as magnesium sulfate, to prevent a first seizure.
Bed rest
If you aren't near the end of your pregnancy and you have a mild case of preeclampsia, your doctor may recommend bed rest to lower your blood pressure and increase blood flow to your placenta, giving your baby time to mature. You may need to lie in bed, only sitting and standing when necessary. Or you may be able to sit on the couch or in bed and strictly limit your activities. Your doctor may want to see you a few times a week to check your blood pressure, urine protein levels and your baby's well-being.
If you have more severe preeclampsia, you may need bed rest in the hospital. In the hospital, you may have regular nonstress tests or biophysical profiles to monitor your baby's well-being and measure the volume of amniotic fluid. A lack of amniotic fluid is a sign of poor blood supply to the baby.
Delivery
If you're diagnosed with preeclampsia near the end of your pregnancy, your doctor may recommend inducing labor right away. The readiness of your cervix — whether it's beginning to open (dilate), thin (efface) and soften (ripen) — also may be a factor in determining whether or when labor will be induced.
In more severe cases, it may not be possible to consider your baby's gestational age or the readiness of your cervix. If it's not possible to wait, your doctor may induce labor or schedule a C-section earlier in your pregnancy. During delivery, you may be given magnesium sulfate intravenously to increase uterine blood flow and prevent seizures.
After delivery, expect your blood pressure to return to normal within a few weeks.
- Pregnancy. National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/hbp/issues/preg/preg.htm. Accessed March 9, 2011.
- Conde-Agudelo A, et al. Maternal infection and risk of preeclampsia: Systematic review and metaanalysis. American Journal of Obstetrics and Gynecology. 2008;198:7.
- Bodnar LM, et al. Maternal vitamin D deficiency increases the risk of preeclampsia. Journal of Clinical Endocrinology & Metabolism. 2007;92:3517.
- High blood pressure and preeclampsia. March of Dimes. http://www.marchofdimes.com/complications_preeclampsia.html. Accessed March 9, 2011.
- Norwitz ER, et al. Management of preeclampsia. http://www.uptodate.com/home/index.html. Accessed March 7, 2011.
- Leanos-Miranda A, et al. Urinary prolactin as a reliable marker for preeclampsia, its severity, and the occurrence of adverse pregnancy outcomes. Journal of Clinical Endocrinology & Metabolism. 2008;93:2492.
- August P, et al. Clinical features, diagnosis, and long-term prognosis of preeclampsia. http://www.uptodate.com/home/index.html. Accessed March 7, 2011.
- Sibai BM, et al. Hypertension. In: Gabbe SG, et al. Obstetrics: Normal and Problem Pregnancies. 5th ed. Philadelphia, Pa.: Churchill Livingstone Elsevier; 2007. http://www.mdconsult.com/das/book/body/208746819-4/0/1528/0.html. Accessed March 9, 2011.
- Barton JR, et al. Prediction and prevention of recurrent preeclampsia. Obstetrics & Gynecology. 2008;112:359.
- Bellamy L, et al. Pre-eclampsia and risk of cardiovascular disease and cancer in later life: Systematic review and meta-analysis. British Medical Journal. 2007;335:974.
- Facchinetti F, et al. Migraine is a risk factor for hypertensive disorders in pregnancy: A prospective cohort study. Cephalalgia: An International Journal of Headache. 2009;29:286.
- Steegers EA, et al. Pre-eclampsia. The Lancet. 2010;376:631.
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