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Postpartum

Postpartum. Greatest risk of eclampsia is 48 hours after delivery Continue Magnesium for 24 hours after delivery Closely monitor BP for 72 hours postpartum (could be at home under special circumstances ).

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Postpartum

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  1. Postpartum • Greatest risk of eclampsia is 48 hours after delivery • Continue Magnesium for 24 hours after delivery • Closely monitor BP for 72 hours postpartum (could be at home under special circumstances)

  2. Treat PP blood pressures if SBP > 150/100 at least 4 hours apartper guidelines, but can also treat if “persistently elevated” i.e. increase frequency of monitoring and don’t have to wait 4h before treating

  3. Postpartum Antihypertensives • Oral nifedipine XL 30 mg daily • Oral labetalol 100-200 mg TID to start • If HTN persists > 24 hours avoid NSAIDS (probably a good idea to avoid in all with with hypertension) • BP needs to be rechecked 7-10 days after discharge, sometimes sooner

  4. Future Risk • 2X increased risk of later-life CV disease (MI, CVA, CHF) in all pre-e (based on large epidemiological studies) • 8-9X increased risk in pre-e delivered before 34 wks • Pregnancy hx should be part of CV risk assessment

  5. Future Risk Prevention • Pts should be advised: • Maintain ideal body weight • Aerobic exercise 5X/wk • Diet high in fiber/veggies/fruits, low in fat • Avoid tobacco • Task Force Recommendation (low quality evidence, qualified recommendation) • Hx of preterm delivery (<37 wks) for pre-e or hx of recurrent pre-e get yearly eval of BP, Lipids, fasting glucose, BMI

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