The usual course of treatment for preeclampsia-especially if it is severe and if you are at least 33 weeks into your pregnancy-is to induce labor immediately. However, this approach may not be safest for your baby-the more premature a baby is born, the greater the risk of long-term complications and death.
Your baby may benefit more from a period of expectant management. During this time, corticosteroid drugs may be administered to help develop your baby’s lungs more quickly. Expectant management is not recommended even if your cervix is unfavorable for induced labor, if you have severe preeclampsia and if you are between the 37th and 40th weeks of pregnancy.
Overall, your doctor considers the severity of your disorder, your baby’s development, and the condition of your cervix before inducing labor. Delivery by cesarean section may be recommended, especially if your cervix is not ?ripe? (soft, thin, and/or dilated) and you are between 28 and 32 weeks pregnant.
If delivery is delayed, you will probably be hospitalized and put on bedrest. You and your baby are closely monitored. Your blood pressure is measured every four to six hours, and your knee reflexes and weight are assessed daily. You will also be asked to let your health care provider know as soon as possible if you experience headaches, vision changes, or pain in your upper abdomen. About three times per day, your baby’s heart rate is monitored. Also, lab tests are done-including measurements of your blood counts and levels of serum transaminases, lactate dehydrogenase, and uric acid (to evaluate your liver and kidney function)-once or twice a week depending on the severity of preeclampsia.
If you are between 32 and 34 weeks, an amniocentesis (samples of the amniotic fluid surrounding the fetus) are performed as needed to assess the maturity of your baby’s lungs. During this procedure, under ultrasound guidance, your doctor inserts a needle through your abdomen and uterus, into the amniotic sac that surrounds your baby. Fluid is aspirated (removed) and tested for proteins, which indicate fetal lung maturity.
Every three to four weeks, ultrasound images are taken to monitor your baby’s growth. Ultrasound uses sound waves to create images. It does not use radiation and is not harmful to you or your baby.