ABSTRACT
The signs and symptoms of pre-eclampsia are many and include: visual disturbance; flashing lights; headache; epigastric pain; raised blood pressure (BP); hyper-reflexia; clonus; changes in optic fundi; epigastric or liver edge tenderness; and oedema. BP should be recorded with the cuff at the level of the heart. The diastolic pressure is taken as abolition of heart sounds. Post-delivery the hydralazine should be reduced after 4 h by 1mg/h. If the BP rises during this reduction nifedipine 5-10 mg sublingually may be used as required to control BP. Urine output measurement and urinalysis should be performed hourly. BP measurements should be taken every 15 min using an automated blood pressure recorder and checked manually using a sphigmomanometer and stethoscope every hour. Intensive therapy unit charts should be filled in at least hourly. The hourly fluid intake, urine output and fluid balance, BP central venous pressure, oxygen saturation and blood results should all be recorded, filling in important events.
