• Past medical history
  • Hypertension medications
  • Prenatal care
  • Prior pregnancies/births
  • Gravida/para


Significant Findings:


  • Vaginal bleeding
  • Abdominal pain
  • Hypertension
  • Severe Headache
  • Blurred vision
  • Edema of hands and face
  • Seizures
  • Dizziness
  • Confusion




  • Preeclampsia/eclampsia
  • Placenta previa (placenta covers cervical opening)
  • Placenta abruption (separation of placenta from uterine wall) Spontaneous abortion
  • Ectopic pregnancy




  • Oxygen
  • Initiate IV
  • 12-Lead EKG




Seizure or seizure-like activity ?


  • Yes


    • Obtain BGL


Improvement ?


  • No



  • Yes


    • Transport left lateral recumbent and notify receiving facility or contact Medical Control


Pre-Eclampsia: ?


    • Severe headache
    • Vision changes
    • RUQ pain
    • Hypertension
    • Edema of hands and feet
    • Sudden weight gain


  • Yes


    • Continue to monitor


    • Transport left lateral recumbent and notify receiving facility or contact Medical Control




  • Typically seen after the 20th week of pregnancy.
  • If IV is unobtainable:
  • Magnesium Sulfate can be administered IM
  • Administer 4 grams / 8 mL in each dorsogluteal muscle (upper buttocks) for a total of 8 grams / 16 mL (5 mL max each site).
  • Multiple sites are necessary
  • Magnesium Sulfate can cause hypotension and respiratory depression; be prepared to aggressively manage the patient's airway and blood pressure.
  • In the setting of pregnancy, hypertension is defined as a systolic blood pressure greater than 160 or diastolic blood pressure greater than 90, or a relative increase of 30 systolic and 20 diastolic from the patient's normal (pre-pregnancy) blood pressure.


Placenta Abruptio


  • usually occurs after 20 weeks gestation.
  • S/S: painful 3rd trimester dark red vaginal bleeding, hypotension, tachycardia.


Placenta Previa


  • can occur during 2nd and 3rd trimester.
  • S/S: painless bright red vaginal bleeding, possible hypotension, tachycardia.


Physiologic changes during pregnancy:


  • Tachycardia
  • Tachypnea
  • T wave changes in II, avF, avL.