Management of preeclampsia

Mrs AB was admitted to the delivery unit during her 35th week of gestation because of severe preeclampsia. She had several laboratory features that suggested the true severity of her disease. The massive proteinuria identified her as having far advanced disease. This was confirmed by the presence of hemoconcentration, hemolysis, and a large number of abnormal laboratory values. Mrs AB's fetus was normally grown (absence of fetal growth retardation), and there was an adequate amniotic fluid volume. Despite these favorable features and the initial presence of long-term fetal heart rate variability, the fetus did not tolerate the induction of labor, and a cesarean delivery was performed. The anesthesia, surgery, and postpartum courses were uncomplicated. Moreover, blood pressure promptly returned to normal after the onset of a brisk diuresis.