Rest as an essential part of pre-eclampsia management

Once pre-eclampsia has been diagnosed, the mother is likely to be advised to rest as much as she possibly can. The logic behind the advice is simple: Because one of the hallmarks of pre-eclampsia is reduced blood-flow to the uterus, the placenta and ultimately the fetus, rest is meant to make the best of a bad situation. It means that blood which would normally be diverted to the active muscles when the mother engages in physical activities is, with rest, allowed to go to the womb.

Rest is therefore an important, sometimes crucial, component of pre-eclampsia control.

Medication: With pre-eclampsia, the expectant mother may be put on medication to try to control the blood pressure. The sole aim of using antihypertensive medication is to protect the mother from dangerously raised blood pressure, which may cause such complications as stroke. It is therefore, purely a complication prevention measure and not a treatment for pre-eclampsia. It does not prevent the core progression of the disease.

Monitoring: The blood pressure will be monitored closely. How closely will depend on how high it is, as well as how abnormal the other parameters are.

Pre-eclampsia diagnosis

Pre-eclampsia can only be diagnosed if the raised blood pressure is accompanied by loss of protein in the urine. This is brought about by the effects of the disease on the kidneys.

The mother will, therefore, have her urine checked very frequently to monitor the level of protein loss. This is one of the principal means of determining the progression of the condition.

She may have her total urine collected for 24 hours, for a quantitative analysis of the protein loss. This is considered superior as a way of analyzing and determining the extent of the protein loss and, by implication, the severity of the condition.

Hospitalization with pre-eclampsia

An expectant mother with pre-eclampsia might need hospital admission. If the obstetrician looking after her feels it unsafe to monitor the condition at home, she may be advised to stay in hospital for a closer, continuous observation of her and her baby’s condition. This will include:

Ø Monitoring symptoms

Ø Monitoring blood pressure

Ø Monitoring protein loss in the urine

Ø Monitoring urine output (reduction in amount is not a good sign)

Ø Monitoring fetal well-being

Ø A battery of blood tests to monitor vital organ (kidneys, liver etc.) function

If the condition is judged to be only mild, she will be monitored at home, probably with visits from the community midwife. The frequency of the visits could range from daily to twice weekly or so, depending on her obstetrician's assessment and opinion.

Plenty of rest will be part of any plan of management.

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