2.  To educate pregnant women on the importance of prenatal care and educate them on the complications that pertain to human pregnancy.  To be knowledgeable of signs and symptoms of preeclampsia  To be knowledgeable of eclampsia and what signs to report to physician  To be knowledgeable of what HELLP syndrome is and the consequences it can have on a patient and their baby  To educate my co-workers of signs and symptoms of preeclampsia, eclampsia and HELLP syndrome to safely manage our patients and their unborn child.  To be knowledgeable of eclamptic lab values (CBC, CMP, Uric acid, LDH,)  To be knowledgeable of normal/abnormal urine results (proteinuria)  To educate pregnant women on the importance of prenatal care and educate them on the complications that pertain to human pregnancy.  To be knowledgeable of signs and symptoms of preeclampsia  To be knowledgeable of eclampsia and what signs to report to physician  To be knowledgeable of what HELLP syndrome is and the consequences it can have on a patient and their baby  To educate my co-workers of signs and symptoms of preeclampsia, eclampsia and HELLP syndrome to safely manage our patients and their unborn child.  To be knowledgeable of eclamptic lab values (CBC, CMP, Uric acid, LDH,)  To be knowledgeable of normal/abnormal urine results (proteinuria)

3.  Population : Pregnant women in 3 rd trimester  Intervention : What is the best prevention treatment for high blood pressure in pregnancy- MgSo4 infusion therapy, IV push drugs or oral medications?  Comparison : Caucasian vs. African American females  Outcome : To decrease high blood pressure which can lean to preeclampsia, eclampsia or HELLP syndrome in pregnancy  Population : Pregnant women in 3 rd trimester  Intervention : What is the best prevention treatment for high blood pressure in pregnancy- MgSo4 infusion therapy, IV push drugs or oral medications?  Comparison : Caucasian vs. African American females  Outcome : To decrease high blood pressure which can lean to preeclampsia, eclampsia or HELLP syndrome in pregnancy

4.  A multisystem disorder characterized by elevated blood pressure and proteinuria that is unique to human pregnancy. › Because the cause is largely hypertension, it is more frequently seen in African American patients, women of maternal age or obese.  The Magpie trial Collaborative Group, 2002 did an international large controlled, randomized study of 10,110 women to evaluate the effects of MgSo4 on women and their babies  Conclusion : MgSo4 therapy halves the risk of eclampsia, and reduces risk of placental abruption by 27% and the risk of maternal death by 45%.  A multisystem disorder characterized by elevated blood pressure and proteinuria that is unique to human pregnancy. › Because the cause is largely hypertension, it is more frequently seen in African American patients, women of maternal age or obese.  The Magpie trial Collaborative Group, 2002 did an international large controlled, randomized study of 10,110 women to evaluate the effects of MgSo4 on women and their babies  Conclusion : MgSo4 therapy halves the risk of eclampsia, and reduces risk of placental abruption by 27% and the risk of maternal death by 45%.

5.  Commonly defined as a new onset of Grand-Mal seizure activity in pregnant women that are not otherwise related to an existing brain condition.  Muscle aches and pains  Seizures  Severe agitation  Unconsciousness  Severely elevated BP’s  Eclampsia follows a pre-existing condition called preeclampsia with elevated BP’s, excess and rapid weight gain (>2lbs/wk).  Commonly defined as a new onset of Grand-Mal seizure activity in pregnant women that are not otherwise related to an existing brain condition.  Muscle aches and pains  Seizures  Severe agitation  Unconsciousness  Severely elevated BP’s  Eclampsia follows a pre-existing condition called preeclampsia with elevated BP’s, excess and rapid weight gain (>2lbs/wk).

6.  H - hemolysis (breaking down of red blood cells)  EL – elevated liver enzymes  LP – low platelet count › Most common reason for mothers to get ill or die are liver rupture or stroke  cerebral edema or cerebral hemorrhage  H - hemolysis (breaking down of red blood cells)  EL – elevated liver enzymes  LP – low platelet count › Most common reason for mothers to get ill or die are liver rupture or stroke  cerebral edema or cerebral hemorrhage

7.  Monitor BP’s (SBP >140 and/or DBP >90)  Assess reflexes  Assess edema  Ask about visual disturbances  Monitor lab values – CBC, CMP, Uric Acid, LDH  Check for proteinuria  Manage medications  MgSo4 IV infusion  IV push drugs – Labetalol, Hydralazine  Oral medications – Niphedipine, Labetalol, Aspirin, Calcium  Assess for possible transfer to higher level of care  Monitor BP’s (SBP >140 and/or DBP >90)  Assess reflexes  Assess edema  Ask about visual disturbances  Monitor lab values – CBC, CMP, Uric Acid, LDH  Check for proteinuria  Manage medications  MgSo4 IV infusion  IV push drugs – Labetalol, Hydralazine  Oral medications – Niphedipine, Labetalol, Aspirin, Calcium  Assess for possible transfer to higher level of care

8.  Women with preeclampsia or eclampsia have higher risk of:  Preterm delivery that can lead to complications in the baby  Placental abruption of placenta from the uterus  Blood clotting problems Early diagnosis of HELLP syndrome is crucial because the morbidity/mortality rates associated with this syndrome can be as high as 25%. Most often the definitive treatment for these complications are delivery of baby and placenta. Transfusions of some form of blood product is often needed –red cells, platelets or plasma.  Women with preeclampsia or eclampsia have higher risk of:  Preterm delivery that can lead to complications in the baby  Placental abruption of placenta from the uterus  Blood clotting problems Early diagnosis of HELLP syndrome is crucial because the morbidity/mortality rates associated with this syndrome can be as high as 25%. Most often the definitive treatment for these complications are delivery of baby and placenta. Transfusions of some form of blood product is often needed –red cells, platelets or plasma.

9.  Unfortunately there is still no tool to aid the early diagnosis of pre-eclampsia; therefore pregnant women will continue to present with severe pre- eclampsia and will require quick and effective management from a collaborative team of healthcare professionals. › This disease can come on quick and if symptoms are not related to the physician, it can have devastating effects on the patient and her unborn child  Preeclampsia (PE) is a serious multisystem disorder in pregnancy and is a leading cause of maternal and fetal morbidity and mortality worldwide (Wiebke, Sarosh & Holger, 2013).  Unfortunately there is still no tool to aid the early diagnosis of pre-eclampsia; therefore pregnant women will continue to present with severe pre- eclampsia and will require quick and effective management from a collaborative team of healthcare professionals. › This disease can come on quick and if symptoms are not related to the physician, it can have devastating effects on the patient and her unborn child  Preeclampsia (PE) is a serious multisystem disorder in pregnancy and is a leading cause of maternal and fetal morbidity and mortality worldwide (Wiebke, Sarosh & Holger, 2013).

10.  Altman, D., Carroli, G., Duley, L., Farrell, B., Moodley, J., Neilson, J., & Smith, D. (2002). Do women with pre-eclampsia, and their babies, benefit from magnasium sulphate? the magpie trial: a randomized placebo- controlled trial. Europepmc, 359(9321), 1877-1890. Retrieved from http://www.europepmc.org  Eiland, E., Nzerue, C., & Faulkner, M. (2012). Preeclampsia 2012. Hindawi publishing corporation: Journal of Pregnancy, 2012, 7 pages. doi: 10.1155/2012/586578  Foundation, P. (November, 2013 25). HELLP syndrome. Retrieved from http://www.preeclampsia.org/health-information/hellp http://www.preeclampsia.org/health-  Health, U.D. (October, 2013 31). Eclampsia. Retrieved from Medline Plus: http://www.nlm.nih.gov/medlineplus/ency/article/000899.htm  (n.d.). Retrieved from http://www.nursing-theory.org  Morley, A. (2004). Pre-eclampsia: Pathophysiology and its management. British journal of midwifery, 12(1), 30-37.  Wiebke, S., Sarosh, R., & Holger, S. (2013). The course of angiogenic factors in early- vs. late onset preeclamppsia and HELLP syndrome. Perinatal Med.,41(5), 511-516. doi: 10.1515