Last reviewed: June 2020
Last updated: February  2020

Summary

Definition

History and exam

Key diagnostic factors

  • >20 weeks' gestation
  • BP ≥140 mmHg systolic and/or ≥90 mmHg diastolic and previously normotensive
  • headache
  • upper abdominal pain

Other diagnostic factors

  • reduced fetal movement
  • fetal growth restriction
  • oedema
  • visual disturbances
  • seizures
  • breathlessness
  • oliguria
  • hyper-reflexia and/or clonus

Risk factors

  • primiparity
  • pre-eclampsia in previous pregnancy
  • family history of pre-eclampsia
  • BMI >30
  • maternal age >40 years
  • multiple (twin) pregnancy
  • sub-fertility
  • gestational hypertension
  • pre-existing diabetes
  • polycystic ovary syndrome (PCOS)
  • autoimmune disease
  • renal disease
  • pre-existing cardiovascular disease and chronic hypertension
  • interval of ≥10 years since previous pregnancy
  • high-altitude residence

Diagnostic investigations

1st investigations to order

  • urinalysis
  • fetal ultrasound
  • umbilical artery Doppler velocimetry
  • amniotic fluid assessment
  • fetal cardiotocography
  • FBC
  • liver function tests
  • serum creatinine
  • placental growth factor
More 1st investigations to order

Treatment algorithm

Contributors

James J. Walker

Professor

Academic Department of Obstetrics and Gynaecology

Leeds Teaching Hospitals Trust

Leeds

UK

Disclosures

JJW is a Medical Director of Action on Preeclampsia (UK) (honorary). He has carried out previous consultancy work for SPI (Swiss Precision Instruments), paid, but not in the last 5 years. Expert witness in medico-legal cases both for plaintiff and defendant on various obstetric topics including pre-eclampsia. JJW has no current grants in the subject. He lectures on pre-eclampsia by invitation but not on behalf of companies. No current patents. Nil else.

Clinical Research Training Fellow

Leeds Institute of Cardiovascular and Metabolic Medicine

University of Leeds

Leeds

UK

Disclosures

LM declares that she has no competing interests.

Peer reviewersVIEW ALL

Professor

Department of Obstetrics & Gynecology

University of Washington

Seattle

WA

Disclosures

TRE declares that he has no competing interests.

Professor of Obstetrics

Maternal and Fetal Research Unit

St Thomas' Hospital

King's College London

London

UK

Disclosures

Not disclosed.

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