Term Preeclampsia

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***# Mild-range pressure, rule out pre-eclampsia
- patient risk factors for pre-eclampsia include ***
- presently asymptomatic
- with mild-range pressure in Ob Triage, will collect CBC, CMP, P/Cr, and Uric Acid to assess labs for end organ damage
- in the interim, cycle BP q15m***

***# Pre-eclampsia, at term, superimposed without severe features
- Diagnosed by SBP greater than 140mmHg / DBP greater than 90mmHg on two occasions at least four hours apart***
- Diagnosed by a single SBP greater than 160 / DBP greater than 110 within a short interval***
- and proteinuria (P/Cr 300mg), thrombcytopenia, renal insufficiency, impaired liver function, cerebral or visual symptoms, pulmonary edema***
- given that this patient is at term, delivery is indicated***

***# Pre-eclampsia, at term, superimposed*** with severe features
- severe features by SBP >160 DBP >110 on two occasions at least four hours apart***
- severe features by thrombocytopenia***
- severe features by impaired liver function as indicated by LFTs persistent RUQ pain***
- severe features as indicated by progressive renal insufficiency***
- severe features by pulmonary edema***
- severe feature as indicated by new-onset cerebral or visual disturbances not relieved by headache cocktail***
- given that the patient is term, will proceed with delivery***
- initiate 4g magnesium IV bolus followed by 2g/hr IV; continue until 24h postpartum for eclampsia prophylaxis***
- magnesium checks q3-4h***

***# HELLP syndrome; pre***term
- initiate 4g magnesium IV bolus followed by 2g/hr IV***
- treat severe range pressures as indicated***
- monitor CBC, CMP q6h; discontinue following appropriate reversal of trend***
- with thrombocytopenia, 10mg Dexamethasone IM q12h, followed by 5mg q12h IM x 2 doses until upward trend in platelets***
- expedite delivery, continue Mangesium until 24h postpartum***

The following labs were ordered in triage:
[ ] CBC
[ ] CMP
[ ] UA
[ ] PC ratio
[ ] Uric acid
[ ] LDH

Yellow *** markers = placeholders you fill in or delete per case.