Outline the obstetric management of preeclampsia.
Obstetric management of the patient with preeclampsia is aimed at controlling the disease and preventing its progression. The patient should be on complete bed rest with left uterine displacement. Serial determinations of blood pressure, weight gain, renal and coagulation function, and central nervous system irritability should be done. Oral fluid and sodium intake should not be restricted. The routine use of diuretics to control edema is no longer recommended.
Fetal well-being should be monitored via a non-stress test, oxytocin challenge, or biophysical profile. Delivery of the fetus and placenta is considered the definitive treatment of preeclampsia and should be done for either fetal or maternal reasons. Fetal indications include evidence of fetal distress or cessation of fetal maturation. Maternal indications include worsening preeclampsia that cannot be controlled medically.