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Pre-eclampsia affects 2–8% of pregnancies worldwide. [4] [17] [12] Hypertensive disorders of pregnancy (which include pre-eclampsia) are one of the most common causes of death due to pregnancy. [6] They resulted in 46,900 deaths in 2015. [7] Pre-eclampsia usually occurs after 32 weeks; however, if it occurs earlier it is associated with worse ...
The use of intravenous or intramuscular magnesium sulfate improves outcomes in those with severe pre-eclampsia and eclampsia and is generally safe. [ 4 ] [ 13 ] Treatment options include blood pressure medications such as hydralazine and emergency delivery of the baby either vaginally or by cesarean section .
Commonly used tocolytic medications include β 2 agonists, calcium channel blockers, NSAIDs, and magnesium sulfate. These can assist in delaying preterm delivery by suppressing uterine muscle contractions and their use is intended to reduce fetal morbidity and mortality associated with preterm birth. [2]
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As a bronchodilator after beta-agonist and anticholinergic agents have been tried, e.g. in severe exacerbations of asthma. [4]Obstetrics: Magnesium sulfate is used to prevent seizures in women with preeclampsia and eclampsia, and is also used for fetal neuroprotection in preterm deliveries, but has been shown to be an ineffective tocolytic agent.
Magnesium sulfate is effective in decreasing the risk that pre-eclampsia progresses to eclampsia. [24] Intravenous magnesium sulfate is used to prevent and treat seizures of eclampsia. It reduces the systolic blood pressure but does not alter the diastolic blood pressure, so the blood perfusion to the fetus is not compromised. It is also ...
Severe pre-eclampsia involves a BP over 160/110 (with additional signs). It affects 5–8% of pregnancies. [20] Eclampsia – seizures in a pre-eclamptic patient, affect around 1.4% of pregnancies. [21] Gestational hypertension can develop after 20 weeks but has no other symptoms, and later rights itself, but it can develop into pre-eclampsia. [22]
Further research explores the management of postpartum hypertension, including the use of home blood pressure monitoring, pharmacological treatments, and magnesium sulfate regimens for preeclampsia, with emphasis on addressing disparities in care access and outcomes relating to race, ethnicity, and social determinants of health. [15]