Management

Management of preeclampsia depends upon its severity as well as the gestational age at which it becomes clinically apparent. While in most cases, diagnosis is made by the appearance of new-onset gestational hypertension accompanied by proteinuria, observations over the last two decades—which are discussed in detail in other chapters— have emphasized the importance of endothelial cell injury and multiorgan dysfunction as integral parts of the preeclampsia syndrome. The basic management objectives for any pregnancy complicated by preeclampsia are: termination of pregnancy with the least possible trauma to mother and fetus, birth of an infant who subsequently thrives, and complete restoration of health to the mother. In certain women with preeclampsia, especially those at or near term, all three objectives are served equally well by induction of labor. One of the most important clinical questions for successful management is precise knowledge of the age of the fetus.