Investigations
1st investigations to order
urinalysis
Test
Because women with gestational hypertension are at increased risk of pre-eclampsia, a urine dipstick test is recommended on each antenatal visit.
Result
negative or <2+ protein
FBC
Test
Baseline test to screen for pre-eclampsia at diagnosis.
Result
within pregnancy-specific thresholds
LFTs
Test
Baseline test to screen for pre-eclampsia at diagnosis.
Result
within pregnancy-specific thresholds
electrolytes, urea, creatinine
Test
Baseline test to screen for pre-eclampsia at diagnosis.
Result
within pregnancy-specific thresholds
Investigations to consider
uric acid
Test
May be considered to screen for pre-eclampsia, although it is neither sensitive nor specific.
Result
may be elevated in pre-eclampsia
24-hour BP monitoring
Test
Useful if static BPs are equivocal.
Result
elevated
fetal ultrasound
Test
Recommended on diagnosis.
Result
baseline estimation of fetal weight and amniotic fluid index
umbilical artery Doppler velocimetry
Test
Recommended on diagnosis.
Result
baseline estimation of vascular haemodynamics, including end diastolic flow
proteinuria (spot testing, 24-hour urine collection)
Test
This will rarely be required in women who have a negative urinalysis for protein.
Twenty-four hour urine collection is awkward for women and, where available, alternative spot tests such as protein:creatinine ratio and albumin:creatinine ratio are preferred.[1][6]
Result
protein:creatinine ratio <30 mg/mmol; albumin:creatinine ratio <8 mg/mmol; 24-hour urine collection <300 mg in 24 hours
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