• Severe pre-eclampsia. CALM DOWN – algorithm of actions of medical personnel
To content

Severe pre-eclampsia. CALM DOWN – algorithm of actions of medical personnel

HEALTH OF WOMAN. 2017.10(126):28–33; doi 10.15574/HW.2017.126.28

Medved V. I., Zhuk S. I., Konkov D. G., Bulavenko O. V., Tkachenkо R. Р., Kukuruza I. L.
SI «Institute of Pediatrics, Obstetrics and Gynecology, NAMS of Ukraine», Kyiv
Vinnitsa National Medical University named after MI Pirogov
National Medical Academy of Postgraduate Education PL Shupika, Kyiv

The pre-eclampsia is a potentially serious complication of pregnancy with increasing significance worldwide. Pre-eclampsia is the cause of 9–26% of global maternal mortality and a significant proportion of preterm delivery, and maternal and neonatal morbidity. Incidence is increasing in keeping with the increase in obesity, maternal age, and women with medical comorbidities entering pregnancy. Recent developments in the understanding of the pathophysiology of pre-eclampsia have opened new avenues for prevention, screening, and management of this condition. In addition it is known that pre-eclampsia is a risk factor for cardiovascular disease in both the mother and the child and presents an opportunity for early preventative measures. New tools for early detection, prevention, and management of preeclampsia have the potential to revolutionize practice in the coming years.
The purpose of clinical implementation of the CALM DOWN action algorithm for medical personnel with severe pre-eclampsia will to reduce maternal and perinatal mortality as a result of complex teamwork.
Key words: severe pre-eclampsia, treatment, the algorithm of actions of medical personnel, CALM DOWN, magnesium sulfate, urapidil, labetalol, nifedipine, infusion therapy.


1. Davydova YuV. 2014. Perinatalnyy menedzhment pri preeklampsii s pozitsiy upravleniya riskami. Reproduktivnaya endokrinologiya 4(18):72–73.

2. Konkov DH, Bulavenko OV, Dudnyk VM, Buran VV. 2016. The modern features of pathogenesis1induced prevention of preeclampsia. Perynatolohiya y pedyatriya 1:46–50. doi 10.15574/PP.2016.65.46

3. Stepan H, Kuse-Föhl S, Klockenbusch W, Rath W et al. 2015. Diagnosis and Treatment of Hypertensive Pregnancy Disorders. Guideline of DGGG (S1-Level, AWMF Registry 015/018, December 2013). Geburtshilfe Frauenheilkd. 75(9):900–914.

4. Diagnosis, evaluation, and management of the hypertensive disorders of pregnancy / LA Magee, A. Pels, M. Helewa, E. Rey, P. von Dadelszen, and  Canadian Hypertensive Disorders of Pregnancy (HDP) Working Group. Pregnancy Hypertens. 2014. 4(2):105–45.

5. Hypertension in Pregnancy. Report of the American College of Obstetricians and Gynecologists’ Task Force on Hypertension in Pregnancy. Obstetrics & Gynecology. 2013. 122;5:1122–1131. PMid:24150027

6. Hypertension in Pregnancy: The Management of Hypertensive Disorders During Pregnancy. NICE Clinical Guidelines. National Collaborating Centre for Women’s and Children’s Health (UK). London, RCOG Press. 2011: 295.

7. Tessa E.R. Gillon, A. Pels, P. von Dadelszen et al. 2014. Hypertensive disorders of pregnancy: a systematic review of International Clinical Practice Guidelines. International Clinical Practice Guidelines. PLoS ONE 9(12):e113715. https://doi.org/10.1371/journal.pone.0113715; PMid:25436639 PMCid:PMC4249974

8. Townsend R, O’Brien P, Khalil A. 2016. Current best practice in the management of hypertensive disorders in pregnancy. Integrated Blood Pressure Control. 9:79–94. https://doi.org/10.2147/IBPC.S77344; PMid:27555797 PMCid:PMC4968992

9. Lowe SA, Bowyer L, Lust K, McMahon LP et al. 2015. SOMANZ guidelines for the management of hypertensive disorders of pregnancy 2014. Aust N Z J Obstet Gynaecol. 55(5):e1-29. https://doi.org/10.1111/ajo.12399; PMid:26412014