Last reviewed: September 2018
Last updated: August  2018

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
  • edema
  • visual disturbances
  • seizures
  • breathlessness
  • oliguria
  • hyper-reflexia and/or clonus

Risk factors

  • primiparity
  • preeclampsia in previous pregnancy
  • family history of preeclampsia
  • BMI >30
  • maternal age >35 years
  • multiple (twin) pregnancy
  • subfertility
  • gestational hypertension
  • pregestational diabetes
  • polycystic ovary syndrome (PCOS)
  • autoimmune disease
  • renal disease
  • chronic hypertension
  • BP ≥80 mmHg diastolic at booking
  • interval of 10 years or more since previous pregnancy
  • high-altitude residence

Diagnostic investigations

1st investigations to order

  • urinalysis
  • fetal ultrasound
  • fetal cardiotocography
  • fetal biometry
  • umbilical artery Doppler velocimetry
  • amniotic fluid assessment
  • CBC
  • liver function tests
  • serum creatinine
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

James J. Walker

Professor

Academic Department of Obstetrics and Gynaecology

Leeds Teaching Hospitals Trust

Leeds

UK

Disclosures

JJW is Medical Director of Action on Pre-eclampsia (unpaid position). JJW lectures on pre-eclampsia at educational meetings (unpaid). He is a member of the International Society for the study of Hypertension in Pregnancy, and contributes towards guideline development in hypertension in pregnancy.

Clinical Research Fellow

Leeds Institute of Cardiovascular and Metabolic Medicine

University of Leeds

Leeds

UK

Disclosures

LM declares that she has no competing interests.

Peer reviewers VIEW 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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