ABSTRACT
The members of the Society of Perinatal Obstetricians were surveyed regarding management
of preeclampsia, with focus on drug therapy, use of invasive monitors, and both general
policies and treatment of hypothetical cases of preterm severe preeclampsia. There
was agreement that magnesium sulfate should be given to all patients with preeclampsia
during labor and postpartum and that blood pressure should be held to about 160/105
mmHg. The drugs of choice for control of blood pressure were hydralazine, alpha-methyldopamine,
and cardioselective beta-blockers. Most perinatologists use invasive monitors only
for specific indications, but a substantial minority use either arterial lines or
central venous pressure monitors routinely in severe preeclampsia. There was no consensus
with respect to management of preterm, severe preeclampsia, but even among the 49%
of respondents who volunteered an unequivocal policy of “deliver regardless of gestational
age,” over three fourths would hospitalize and observe in selected cases meeting American
College of Obstetrics and Gynecology criteria for severe preeclampsia.
