Delivery is the only cure for preeclampsia. A woman’s blood pressure usually returns to normal within a few days of delivery. However, delivery is not always a safe option. Delivering a baby too early in the pregnancy may be harmful to the baby. As a result, an obstetrician-gynecologist (ObGyns) will always consider the extent of a baby’s development before inducing labor to treat preeclampsia.

In general, physicians will wait to induce labor until after the expectant mother reaches 36 weeks of pregnancy. For the safety of the baby and the expectant mother, a physician will typically not allow a pregnancy complicated with preeclampsia to continue past 40 weeks. The readiness of the cervix is another factor considered before labor is induced. 

When waiting is necessary, there are several methods that may be recommended to manage the preeclampsia, while giving the baby additional time to develop. These methods include:

• Bed rest. Bedrest may be used to increase blood flow to the placenta and lower the expectant mother’s blood pressure. The rules of bedrest vary for each situation. For mild preeclampsia, women may be required to continuously lie in bed, sitting up and standing only when necessary. Other women may be able to sit on the couch or bed, while limiting their activities. Patients on bedrest may be required to visit their ObGyn a few times a week for blood pressure monitoring, urine tests and an evaluation of the baby’s health status. 
  
  For more severe cases of preeclampsia, bedrest in a hospital may be necessary. During her hospitalization, the expectant mother may undergo frequent nonstress tests or biophysical profiles to monitor the baby’s health. Ultrasound exams may also be used to measure the amount of amniotic fluid. A low level of amniotic fluid may be a sign of insufficient blood flow to the baby, and inducing labor may be recommended. 
  
  
• Medications. Although they cannot cure the condition, medications may be used to treat the signs and symptoms of preeclampsia. Antihypertensives, such as beta blockers, may be used to lower blood pressure levels in women who experience hazardous increases in blood pressure. For women with severe preeclampsia, corticosteroids may be used to temporarily improve liver and platelet functioning. Corticosteroids can also help the baby’s lungs develop. Magnesium sulfate also can be given intravenously to prevent the seizures associated with eclampsia.

Women may also be asked to lie on their left side as much as possible. This takes the weight of the baby off the major blood vessels of the body, improving blood flow. Drinking eight glasses of water a day and reducing salt intake may also be recommended. However, a pregnant woman’s body needs a certain amount of salt to maintain the flow of fluid in the body. A woman should ask her physician for a recommendation of how much salt is healthy to consume each day.

In very severe cases of preeclampsia, waiting for the baby to develop or the cervix to prepare may not be possible. It may be too risky to wait when the mother develops:

• Diastolic blood pressure that is consistently higher than 100 mm Hg for a 24-hour period. This is a risk factor for stroke.
  
  
• A confirmed diastolic blood pressure reading over 110 mm Hg. This is a risk factor for stroke.
  
  
• Constant and severe headaches. This is a risk factor for seizures.
  
  
• Abnormal liver function tests. This is a risk factor for liver rupture.
  
  
• Persistent abdominal pain. This is a risk factor for liver rupture.
  
  
• Rising serum creatinine levels. This is a risk factor for kidney failure.
  
  
• HELLP syndrome. This is a risk factor for liver failure, coagulation (blood clotting) disorders, and death.
  
  
• Pulmonary edema (fluid and swelling in the lungs). This is a sign of a weakening heart.
  
  
• Eclampsia. This is a risk factor for organ damage, coma, brain damage and death.
  
  
• Thrombocytopenia (a platelet count less than 100,000). This is a risk factor for severe bleeding.
  
  
• Severely decreased urine output. This is a risk factor for kidney failure.

Certain findings during fetal monitoring are also considered reasonable factors for early delivery, including:

• Non-reassuring findings during fetal monitoring (as noted by ultrasound or nonstress test)
  
  
• Failure of fetal growth (as noted by ultrasound)
  
  
• Abnormal biophysical profile
  
  
• Decreased blood flow through the umbilical cord (as noted on Doppler ultrasound tests)
  
  
• Decreased amount of amniotic fluid (as noted on ultrasound)

According to the National Institutes of Health (NIH), prolonging pregnancies in which these conditions have developed commonly result in maternal complications, as well as infant death in about 87 percent of cases. In these situations, a physician may induce labor or perform a Caesarean section before the 36^th week of pregnancy. However, for pregnancies less than 24 weeks the probability of a viable fetus is minimal.

During labor and delivery, the expectant mother may be given magnesium sulfate intravenously to improve blood flow to the uterus and prevent seizures (eclampsia). Magnesium sulfate is usually continued for 24 hours after delivery. A C-section may be chosen over vaginal delivery when either the expectant mother or the fetus may be unable to tolerate labor.

The symptoms of preeclampsia usually disappear within three to seven days of delivery. If the condition lasts beyond this period, it will require long-term treatment, as with other forms of hypertension.