Once your blood pressure is stable, you are not having seizures, and you are well oxygenated, your doctor begins the process of delivery-either by induction (with drugs to stimulate labor) or by caesarean section (C-section). During labor induction or cesarean section, a special catheter is inserted into your bladder so your urine can be measured hourly.

Which delivery method is choosen depends on several factors, including:

  • your condition;
  • your baby's condition;
  • how far along your pregnancy is;
  • whether you are in labor, and
  • whether you are in labor, and
  • the condition of your cervix (how soft, thin, and dilated it is).

If you are more than 30 weeks pregnant, vaginal delivery is the preferred method. Medication such as oxytocin (Pitocin) and dinoprostone (Cervidil), is used to stimulate contractions or soften and shorten your cervix. If your baby is in distress, however, caesarean section is usually performed.

If you are less than 30 weeks pregnant, C-section is the preferred method-because the cervix is not yet ready to dilate and may not respond to oxytocin or other medications. In addition, your baby may not tolerate a long process of induction and stimulation of labor.

Management of Preeclampsia and Eclampsia During Delivery

  • Oxytocin, a hormone produced naturally in the body which stimulates uterine contractions, is often used to start and/or augment labor. Cervical ripening agents (substances which soften, thin, and initially dilate the cervix) such as dinoprostone or prostaglandin E2 (for example, Cervidil or Prepidil) may also be used to stimulate labor.
  • To prevent seizures due to eclampsia and control your blood pressure, you are given intravenous magnesium sulfate during labor and delivery.
  • Intravenous magnesium sulfate commonly causes flushing, sweating, and warmth usually when initially infused. Other common side effects include nausea, vomiting, headaches, and weakness. Your respiratory rate and knee reflexes are checked carefully to monitor your blood magnesium levels. Loss of knee reflexes is the first sign of hypermagnesemia (too much magnesium in your blood). If not controlled, hypermagnesemia can lead to respiratory paralysis and cardiac arrest, which rarely occur with close monitoring. Calcium gluconate is used to decrease excessive blood levels of magnesium.
  • Your fluid levels are also closely monitored to make sure you do not develop edema (fluid) of the lungs, a rare but serious side effect of magnesium therapy.
  • Local anesthesia, epidural anesthesia, or intramuscular or intravenous narcotic analgesics help control pain during labor and delivery.
  • If caesarean delivery is required, you may receive a platelet transfusion (depending on your platelet counts). Depending on clinical and laboratory findings, you may also require other blood products.