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Postpartum Preeclampsia Checklist: Safemotherhoodinitiative

This document provides a checklist for treating postpartum preeclampsia in patients less than 6 weeks postpartum with high blood pressure readings. The checklist outlines steps to call for assistance, administer IV magnesium sulfate to prevent seizures, treat hypertension with antihypertensive medications like labetalol or hydralazine, monitor labs and the patient, and use alternative anticonvulsant medications if magnesium is contraindicated. The goal is to safely manage severe hypertension and prevent complications like seizures in postpartum preeclamptic patients.

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169 views1 page

Postpartum Preeclampsia Checklist: Safemotherhoodinitiative

This document provides a checklist for treating postpartum preeclampsia in patients less than 6 weeks postpartum with high blood pressure readings. The checklist outlines steps to call for assistance, administer IV magnesium sulfate to prevent seizures, treat hypertension with antihypertensive medications like labetalol or hydralazine, monitor labs and the patient, and use alternative anticonvulsant medications if magnesium is contraindicated. The goal is to safely manage severe hypertension and prevent complications like seizures in postpartum preeclamptic patients.

Uploaded by

azima
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Example

Emergency Department
Postpartum Preeclampsia Checklist
If Patient < 6 Weeks Postpartum with:
•  BP ≥ 160/110 or
Magnesium Sulfate
•  BP ≥ 140/90 with unremitting headache, Contraindications: Myasthenia gravis; avoid with
pulmonary edema, use caution with renal failure
visual disturbances, epigastric pain
IV access:
  Call for Assistance
  Load 4-6 grams 10% magnesium sulfate in 100 mL  
  Designate: solution over 20 min
Team leader   Label magnesium sulfate; Connect to labeled infusion
Checklist reader/recorder pump
Primary RN   Magnesium sulfate maintenance 1-2 grams/hour
  Ensure side rails up No IV access:
  Call obstetric consult; Document call   10 grams of 50% solution IM (5 g in each buttock)

  Place IV; Draw preeclampsia labs


 Chemistry Panel
Antihypertensive Medications
CBC
PT  Uric Acid For SBP ≥ 160 or DBP ≥ 110 
 PTT  Hepatic Function (See SMI algorithms for complete management when
necessary to move to another agent after 2 doses.)
Fibrinogen  Type and Screen
  Labetalol (initial dose: 20mg); Avoid parenteral
  Ensure medications appropriate given   labetalol with active asthma, heart disease, or
patient history congestive heart failure; use with caution with
  Administer seizure prophylaxis history of asthma
  Hydralazine (5-10 mg IV* over 2 min); May increase
  Administer antihypertensive therapy
risk of maternal hypotension
Contact MFM or Critical Care for refractory
blood pressure   Oral Nifedipine (10 mg capsules); Capsules should
be administered orally, not punctured or otherwise
  Consider indwelling urinary catheter administered sublingually
Maintain strict I&O —   * Maximum cumulative IV-administered doses should
patient at risk for pulmonary edema not exceed 220 mg labetalol or 25 mg hydralazine in
  Brain imaging if unremitting headache or 24 hours
neurological symptoms Note: If first line agents unsuccessful, emergency
consult with specialist (MFM, internal medicine,
†
”Active asthma” is defined as: OB anesthesiology, critical care) is recommended
A symptoms at least once a week, or
B use of an inhaler, corticosteroids for asthma
Anticonvulsant Medications
during the pregnancy, or
C any history of intubation or hospitalization For recurrent seizures or when magnesium sulfate
for asthma. contraindicated
  Lorazepam (Ativan): 2-4 mg IV x 1, may repeat once
after 10-15 min
  Diazepam (Valium): 5-10 mg IV q 5-10 min

Safe Motherhood Initiative


Revised January 2019

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