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February 2005 · Vol. 17, No. 2

PART 1 OF 3

BEST PRACTICES FOR DIAGNOSIS AND MANAGEMENT OF PREECLAMPSIA

Preeclampsia: 3 preemptive tactics

A strategy to prevent preeclampsia or minimize severity—starting before conception if possible—is the best way to reduce adverse outcomes.


IN THIS ARTICLE

Hallmarks of gestational hypertension, preeclampsia, eclampsia, and HELLP

Fast Track

Any protective effect is lost with change of partner. Primipaternity increases risk of preeclampsia

Frequent testing is advisable for women with unexplained fetal growth restriction

Low-dose aspirin is not advised to prevent preeclampsia when uterine artery resistance is elevated on Doppler testing

Gestational hypertension at 24 to 35 weeks incurs high risk of preeclampsia and preterm birth, and requires close surveillance

Traditional diagnostic criteria are not reliable in women who have hypertension or proteinuria before 20 weeks

Preeclampsia in healthy nulliparous women is hypertension and proteinuria after 20 weeks

Baha  M.  Sibai,  MD

Professor and Chairman, Department of Obstetrics and Gynecology, University of Cincinnati College of Medicine

We routinely use every means possible to overcome the complications of hypertensive disorders and related preterm births. Yet our best opportunity to reduce morbidity and mortality could be before preeclampsia develops.

Preemptive tactics can be effective in preventing or reducing severity of preeclampsia. The patient’s active cooperation is a must, but the effort to recruit her cooperation can mean a better outcome.

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