The nursing care of women critically ill during pregnancy is an ever-changing specialty that presents unique clinical problems and issues. The woman and the fetus can be profoundly affected by the hypertensive disorders of pregnancy. The underlying pathology must be identified in relation to its effects on the pregnancy, the effects of the pregnancy on the disease, and the implications for the woman and the fetus. Severe preeclampsia, the HELLP syndrome (hemolysis, elevated liver enzymes, and low platelets), and eclampsia present such challenges and management problems. This article discusses the pathophysiology and management implications of severe preeclampsia, the HELLP syndrome, and eclampsia

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