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Suspected Preeclampsia Algorithm Severe gestaonal HTN Preeclampsia with severe features no yes no yes If borderline blood pressure (BP) and new onset proteinuria, consider an atypical form of preeclampsia, especially if other signs/labs present (see below) New onset HTN? (≥ 140/90) Gest HTN New onset proteinuria? ≥ 34 weeks gestaon? Preeclampsia New onset HTN? (≥ 160/110) no yes no yes Strongly consider transfer to 3° center Deliver now Check for Persistent: Headache Visual Changes Abdominal Pain New onset proteinuria? Deliver at 37 weeks Thrombocytopenia Elevated LFTs Creanine > 1.2 Elevated LDH OR no no yes yes no no yes yes no no yes yes no no NOTE: There are no longer real differences in management between preeclampsia and gestaonal hypertension (HTN) in BP management and decision to deliver. TREAT BP ACCORDINGLY and DELIVER for abnormal labs or symptoms yes yes Modified from: Maurice L. Druzin, MD; Laurence E. Shields, MD; Nancy L. Peterson, RNC, PNNP, MSN; Valerie Cape, BSBA. Preeclampsia Toolkit: Improving Health Care Response to Preeclampsia (California Maternal Quality Care Collaborave Toolkit to Transform Maternity Care) Developed under contract #11-10006 with the California Department of Public Health; Maternal, Child and Adolescent Health Division; Published by the California Maternal Quality Care Collaborave, November 2013. Presented by Advanced Pracce Strategiesbbbbbbbb

Suspected Preeclampsia Algorithm - mygnosis.com€¦ · Suspected Preeclampsia Algorithm Severe gestational HTN Preeclampsia with severe features no yes no yes If borderline blood

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Suspected Preeclampsia Algorithm

Severe gestationalHTN

Preeclampsia with severe features

no

yes

no yes

If borderline blood pressure (BP) and new onset proteinuria, consider an atypical form of preeclampsia, especially if other signs/labs present (see below)

New onset HTN?(≥ 140/90)

Gest HTN

New onset proteinuria?

≥ 34 weeks gestation?

Preeclampsia

New onset HTN?(≥ 160/110)

no

yes

no yes

Strongly consider transfer to 3° center Deliver now

Check for Persistent:• Headache • Visual Changes • Abdominal Pain

New onset proteinuria?

Deliver at 37 weeks

• Thrombocytopenia • Elevated LFTs • Creatinine > 1.2 • Elevated LDH

OR

nono yesyes nonoyesyes

nono yesyesnono

NOTE: There are no longer real differences in management between preeclampsia and gestational hypertension (HTN) in BP management and decision to deliver. TREAT BP ACCORDINGLY and DELIVER for abnormal labs or symptoms

yesyes

Modified from: Maurice L. Druzin, MD; Laurence E. Shields, MD; Nancy L. Peterson, RNC, PNNP, MSN; Valerie Cape, BSBA. Preeclampsia Toolkit: Improving Health Care Response to Preeclampsia (California Maternal Quality Care Collaborative Toolkit to Transform Maternity Care) Developed under contract #11-10006 with the California Department of Public Health; Maternal, Child and Adolescent Health Division; Published by the California Maternal Quality Care Collaborative, November 2013.

Presented by Advanced Practice Strategiesbbbbbbbb