Just want to add some informations about preeclampsia and severe preeclampsia. In Indonesia....Eclampsia, beside infections and bleeding, is still become one of the main cause of maternal and perinatal mortality in pregnancy. Thus, the early diagnose for preeclampsia, which is the first 'warn' of eclampsia, and also the principal management of it need to be widely introduced and well performed by all general practitioners including midwife and doctors. So then, after the patient's condition is stable, we can refer the patient to the hospital or the expert.
One thing that we should pay attention for is the fact that many preeclamptic women usually do not complain any health problems, until they check their bloodpressure and realize that they've got hypertension..! Unluckily, the eclamptic women can also have normal bloodpressure...
So, it definitely reasonable that the Antenatal Care (ANC) is really important in order to detect the symptoms and signs of preeclampsia such as headache, visual disturbances, epigastric pain, nausea and vomitting, edema (not specific), etc. From the physical examination we can check the bloodpressure, conjunctiva, the lung, the abdomen, and the extrimities. And for the suspicious patients, we can try the protein stick for rapid-test.... Simple but So important, isn't it...
As stated in the previous posting about hypertensive disorders inpregnancy woman, there are 5 types of gestational hypertension which are transient hypertension, preeclampsia, chronic hypertension in the pregnancy woman, superimposed preeclampsia on chronic hypertension, and eclampsia. Each of them have their own characteristics and this scheme is only one of the simple guideline for preeclamptic women:
If the patient comes with severe preeclampsia, the management become like this:
Indications for delivery included uncontrollable blood pressure, fetal distress, placental abruption, renal function deterioration, HELLP syndrome, persistent severe symptoms, or attainment of 34 weeks' gestation. After 34th weeks, the incidence of placental abruption, pulmonary edema, and eclampsia are increased.
Hope it helps, Guys..
I'm sure we can discuss more about it.