Pre-eclampsia describes the emergence of high blood pressure during pregnancy that may be a precursor to a woman developing eclampsia and other complications. It is classically a triad of 3 things:

• new-onset hypertension
• proteinuria
• oedema

*Pre-eclampsia cannot occur before week 20 of pregnancy

Definition

The current formal definition is as follows

• new-onset blood pressure ≥ 140/90 mmHg after 20 weeks of pregnancy, AND 1 or more of the following:
  • proteinuria
  • other organ involvement (see list below for examples): e.g. renal insufficiency (creatinine ≥ 90 umol/L), liver, neurological, haematological, uteroplacental dysfunction

Pathology

• High blood pressure - Caused by a failure of reduced vascular resistance in pregnancy
• Proteinuria - leaking glomeruli
• Oedema - Leaking of capillaries with increased volume and water retention

Prevention

NICE divide risk factors into high and moderate risk:

Reducing the risk of hypertensive disorders in pregnancy

• women with the following should take aspirin 75-150mg daily from 12 weeks gestation until the birth
  • ≥ 1 high risk factors
  • ≥ 2 moderate factors

PC: