Decision
Recheck blood pressure. Is it still elevated?
YES
Administer
- Labetalol IV 10-20 mg (Class II)
OR
- Hydralazine IV 5 mg, or Nifedipine orally 10-20 mg (Class II)
Consult ob/gyn
NO
Refer for follow-up with primary care physician or ob/gyn in 1-2 days for repeat blood pressure check
Background
Diagnostic Criteria for Pre-Eclampsia
- Systolic blood pressure ≥140 mm Hg OR Diastolic blood pressure ≥90 mm Hg
PLUS
- New onset of 1 or more of the following:
- Protein/creatinine ratio >0.3 in a random urine specimen
- Thrombocytopenia (platelets <100,000/mcL)
- Serum creatinine >1.1 or doubling of creatinine concentration in the absence of other renal disease
- Liver transaminases at least twice the upper limit of normal
- Pulmonary edema
- New-onset and persistent headache that is not accounted for by other diagnoses and not responding to usual doses of analgesics
- Visual symptoms
