For women who were previously normotensive, or who had superimposed preeclampsia, more rigorous control of blood pressure is recommended, especially if they show any degree of thrombocytopenia or pulmonary edema. (See Clip & save: Stepwise drug therapy for obstetric hypertensive crisis) The rationale relates to cerebral perfusion pressures and risk of stroke in these susceptible women, if thresholds are exceeded, and to the risk of worsening pulmonary edema in the setting of increased capillary hydrostatic pressure and reduced colloid osmotic pressure.
Additionally, continuation of magnesium sulfate is recommended for patients with superimposed preeclampsia until obvious signs of disease resolution, and for a minimum of 24 hours.
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