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Hypertension & pre-eclampsia
Definitions, admission and timing of birth.
Source: NICE NG133 Calculator
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Definitions
| Chronic | Before 20 weeks or on treatment. |
|---|---|
| Gestational | New ≥140/90 after 20 wk, no proteinuria. |
| Pre-eclampsia | New HTN after 20 wk + uPCR >30 mg/mmol (ACR >8) or organ dysfunction. |
| Severe | ≥160/110. |
Admit pre-eclampsia if
- Sustained systolic ≥160
- Creatinine ≥90 µmol/L
- ALT >70 IU/L
- Platelets <150 × 10⁹/L
- Any clinical concern
Timing of birth
| GHTN / chronic, BP <160/110 | Not before 37+0. |
|---|---|
| PE <34 wk | Surveillance; steroids & MgSO4 if birth planned. |
| PE 34–36+6 | Surveillance; consider steroids. |
| PE ≥37 wk | Birth within 24–48 h. |
After birth
- BP daily for 2 days, then once days 3–5
- Treat if ≥150/100; enalapril (nifedipine/amlodipine for Black African/Caribbean women)
- Stop methyldopa within 2 days
- Review at 6–8 weeks
Do not use steroids to treat HELLP. Severe PE: limit fluids to 80 ml/h.
A summary for trained clinicians. Always check the full guideline, the patient in front of you and your hospital's protocol. Spotted an error? Tell us.