Once you have developed pre-eclampsia, it won’t go away until after your baby is born. To put this another way, there is only one cure for pre-eclampsia and that is the birth of your baby. If you develop pre-eclampsia, you will be referred to an obstetrician or specialist for tests and checks and may require admission to the hospital.
Treatment for pre-eclampsia is aimed at managing the complications of pre-eclampsia so your pregnancy can continue safely. Prolonging the pregnancy means that your baby continues to grow and develop.
If your baby does need to be born early because of complications there are treatments that can decrease the risks for your baby from being born prematurely. Read more about premature birth.
Treatment options for pre-eclampsia include:
Rest and gentle activity
Traditionally, continuous bed rest was recommended for all women with pre-eclampsia, but research has not shown a benefit from this. Actually, ongoing bed rest and lack of activity can increase your risk of blood clots. So for most women, continuous bed rest is no longer recommended but it is a good idea to limit your activity, avoid stress and rest now and again throughout the day.
Severe pre-eclampsia may require you to say in hospital. In the hospital, your doctor will do regular tests and checks to monitor your wellbeing and the wellbeing of your baby.
There are two main reasons for being admitted to hospital. The first is because tests like blood pressure need to be done every few hours. The second is that you or your baby could develop complications quickly and need urgent care.
How is pre-eclampsia monitored?
Sometimes you will be given medication to lower your blood pressure, but the aim will be to not lower the blood pressure too much or too suddenly as this can cause distress to your baby.
- Your blood pressure will be checked about every 4 hours.
- Blood tests and urine protein levels will be regularly tested to check on your kidney function.
- You may be offered an ultrasound scan to look at how your baby is growing and to check the blood flow from the placenta to your baby.
- You may be prescribed medicines to control your blood pressure.
Aspirin has been shown to decrease the chances of a pregnant woman developing pre-eclampsia by about 10%. In other words, it will stop 1 out of 10 pregnant women from getting pre-eclampsia. The dose used is much smaller than the dose you would use for treating a headache, so it is called low-dose aspirin.
Although aspirin is very safe at low doses, no medications should be used in pregnancy unless there is a good reason.
If you think you might benefit from aspirin treatment, talk to your doctor. Aspirin needs to be started before 20 weeks and ideally at 12 weeks to have the best effect. Aspirin does not seem to be of any benefit once pre-eclampsia has been diagnosed and is usually stopped before delivery.
Some women, particularly those with low calcium diets, may also be prescribed calcium.
If your blood pressure rises too high you will normally be prescribed medication to lower it (called antihypertensives). Your doctor will choose an antihypertensive that is considered safe in pregnancy.
Having your blood pressure lowered by a hypertensive does not mean your pre-eclampsia has gone. The blood pressure medication keeps you safe while you wait for your baby to become more mature and better able to cope with the stress of delivery.
Examples of antihypertensives that are commonly used to treat pre-eclampsia include:
To ensure that the medication is working, your doctor will monitor your blood pressure regularly and may adjust your medication dose if necessary.
If your blood pressure drops too low, then the blood flow to the placenta and your baby may fall, and your baby can become distressed. This is why your doctor allows your blood pressure to remain just above the normal range.
Some women with high blood pressure before pregnancy may be on treatment with a group of medications called ACE inhibitors. Women who are planning a pregnancy and using ACE inhibitors should seek advice about changing to a different blood pressure medication.
If delivery is planned and your baby is premature (particularly before 32 weeks), you will usually be given 2 steroid injections 12–24 hours apart, which help to mature your baby’s lungs. Whenever possible the birth will be delayed for 24 hours to give the steroids time to be effective.
You may also be given magnesium sulphate through your vein to prevent seizures. Women who require magnesium treatment have developed severe pre-eclampsia and will almost always need to give birth to their baby within the next 24 hours. Magnesium also crosses over to your baby and helps to protect the baby's brain after birth.
If you're diagnosed with pre-eclampsia near the end of your pregnancy, your doctor may recommend inducing labour right away.
If you are still more than a month away from your due date, or if there are signs that your baby may not cope well with a labour, a caesarean section will be recommended as the safest way to deliver your baby.
In general, if you are close to your due date it is possible to have a normal birth after labour is induced. The baby's heart rate will need to be monitored closely once contractions start because the baby is often smaller than usual.
During labour, you may be offered an epidural, which is usually used for pain relief in labour but also helps to keep your blood pressure under control.