Pre-eclampsia

Pre-eclampsia is a hypertensive syndrome that occurs in pregnant women, most often after 20 weeks' gestation, which consists of new-onset, persistent hypertension with either proteinuria or evidence of systemic involvement.

All pregnant women presenting with hypertension and either proteinuria or evidence of systemic involvement require close assessment and monitoring for pre-eclampsia and its complications.

Delivery is the definitive treatment; the decision about when and how to deliver should only be made after a thorough assessment of the risk and benefits to the mother and baby.

Other mainstays of management include antihypertensive therapy, seizure control, and fluid restriction.

Maternal mortality is highest after delivery, so vigilance should be maintained in the postnatal period.

Pre-eclampsia can occur in subsequent pregnancies; therefore, women should be counselled about the risk.

Pre-eclampsia is a disorder of pregnancy that is associated with new-onset hypertension (defined as a systolic blood pressure ≥140 mmHg and/or a diastolic blood pressure ≥90 mmHg), most often after 20 weeks' gestation and frequently near term. Although often accompanied by new-onset proteinuria, hypertension and other signs or symptoms of pre-eclampsia may present in the absence of proteinuria in some women.[1]American College of Obstetricians and Gynecologists. Practice bulletin no. 222: gestational hypertension and preeclampsia. Jun 2020 [internet publication]. https://www.acog.org/clinical/clinical-guidance/practice-bulletin/articles/2020/06/gestational-hypertension-and-preeclampsia

HELLP syndrome is a subtype of severe pre-eclampsia characterised by haemolysis (H), elevated liver enzymes (EL), and low platelets (LP). The diagnosis and management of HELLP syndrome is not discussed in detail in this topic. See HELLP syndrome.