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Pre-eclampsia is uniquely a disease occurring in the second half of pregnancy
(after 20 weeks gestation), and conventionally, characterised by pregnancy-induced
hypertension, with proteinuria and often with oedema. NICE suggest that
(1): - blood pressure measurement and urinalysis for protein should be
carried out at each antenatal visit to screen for pre-eclampsia
- at the
booking appointment, the following risk factors for pre-eclampsia should be determined:
-
age 40 years or older
- nulliparity
- pregnancy interval of more
than 10 years
- family history of pre-eclampsia
- previous history
of pre-eclampsia
- body mass index 30 kg/m2 or above
- pre-existing
vascular disease such as hypertension
- pre-existing renal disease
- multiple
pregnancy
- more frequent blood pressure measurements should be considered
for pregnant women who have any of the above risk factors
- the
presence of significant hypertension and/or proteinuria should alert the healthcare
professional to the need for increased surveillance
- hypertension in which
there is a single diastolic blood pressure of 110 mmHg or two consecutive readings
of 90 mmHg at least 4 hours apart and/or significant proteinuria (1+) should prompt
increased surveillance
- if the systolic blood pressure is above 160 mmHg
on two consecutive readings at least 4 hours apart, treatment should be considered
- all
pregnant women should be made aware of the need to seek immediate advice from
a healthcare professional if they experience symptoms of pre-eclampsia. Symptoms
include:
- severe headache
- problems with vision, such as blurring
or flashing before the eyes
- severe pain just below the ribs
- vomiting
- sudden swelling of the face, hands or feet
See
the diagnosistic criteria in the linked article. 
Reference: - NICE
(2008). Antenatal care
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