New-onset hypertension after 20 weeks + proteinuria or end-organ dysfunction.
Risk factors
- • Nulliparity, previous PET
- • Multiple pregnancy
- • Pre-existing HTN, DM, CKD, antiphospholipid
Clinical features
- • Often asymptomatic
- • Headache, visual changes
- • Epigastric pain (HELLP)
- • Reduced fetal movements
Investigations
- • BP, urinalysis (PCR/ACR)
- • FBC, U&E, LFT, urate
- • PlGF/sFlt-1 ratio
- • Fetal: CTG, USS growth + Doppler
Management
- • Labetalol first-line (nifedipine, methyldopa)
- • Severe BP: IV labetalol/hydralazine
- • MgSO₄ for eclampsia / severe PET (loading 4 g + 1 g/h)
- • Delivery is definitive; timing balances maternal/fetal risk
- • Aspirin 75–150 mg from 12 weeks in high-risk pregnancies
Complications
- • Eclampsia, stroke
- • HELLP, DIC
- • Abruption, IUGR
- • Pulmonary oedema, AKI
Clinical pearls
- • Continue antihypertensives postpartum; reassess at 6 weeks
- • Future CV risk — lifestyle counselling
Related in WardRound
Educational — verify locally.
