If you have extremely elevated blood pressure when hospitalized, you may be given medication intravenously to lower your blood pressure. Anti-hypertensive medications proven safe for intravenous use during pregnancy include hydralazine (Apresoline) and labetalol (Normodyne, Trandate). These drugs also help prevent cerebral hemorrhage (bleeding of the brain), which is a complication of severe preeclampsia and eclampsia. You may need to receive oxygen as well, which will maintain your blood oxygen saturation.
Urine and blood tests detect abnormalities associated with severe preeclampsia and eclampsia, including:
- increased protein in the urine;
- elevated blood cell count (specifically the hematocrit level);
- elevated blood levels of proteins (such as lactate dehydrogenase);
- elevated transaminase levels (liver enzymes);
- elevated uric acid levels;
- decreased blood platelet count; and
- alterations in blood clotting factors.
Your doctor will also determine whether you have developed HELLP syndrome, a variant of severe preeclampsia, characterized by:
- hemolysis (destruction of red blood cells);
- elevated liver enzymes (indicative of liver damage); and
- low blood platelet levels (indicative of impaired blood clotting, which can cause problems during and after labor).
These findings indicate abnormal liver or kidney function, among other conditions.
Your treatment depends on the extent of your symptoms, your blood pressure, laboratory findings, whether you are experiencing organ failure, and how near to term you are. If you have eclampsia or HELLP Syndrome (or both), the standard course of action is to deliver the baby-either vaginally or by caesarean section-as soon as your condition is stable and the seizures have ceased. Delivery is usually associated with reversal of laboratory abnormalities and normalization of organ function.