Red flags
- BP ≥160/110 with proteinuria, headache, visual change
- PV bleed soaking pads, hypotension
First steps
- Left lateral tilt, 2 IV, group & crossmatch 4 units
- Call obstetric & anaesthetic teams
Key investigations
- CBC, coags, fibrinogen
- RFT, LFT, urate, urine PCR
- CTG, USG
Differentials
- PPH (4 Ts)
- Pre-eclampsia / eclampsia
- Sepsis, amniotic fluid embolism
Initial management
- PPH: uterine massage, oxytocin 10 IU IM/IV, tranexamic acid 1 g
- Eclampsia: MgSO₄ 4 g IV over 5 min, then 1 g/h
- BP control: labetalol 20 mg IV or hydralazine 5 mg IV
- Definitive: delivery once stabilized
Referral
- Obstetrics, Anaesthesia, Neonatology
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