Women who are at risk of pre-eclampsia should take Aspirin, 75mg OD from 12 weeks until the birth of the baby.
Those who are at high risk of developing pre-eclampsia include:
- hypertensive disease during previous pregnancies
- chronic kidney disease
- autoimmune disorders such as SLE or antiphospholipid syndrome
- type 1 or type 2 diabetes
The classification of hypertension in pregnancy is usually defined as:
- SBP > 140mmHg or DBP > 90mmHg
- or an increase above booking reading of Systolic > 30mmHg or diastolic > 15 mmHg
If you’ve decided they are hypertensive you need to categorise them into one of three groups:
- Pre-existing hypertension
- Pregnancy-induced hypertension (PIH aka Gestational hypertension)
- History of hypertension before pregnancy or an elevated BP > 140/90 before 20weeks.
- No proteinuria, No oedema
- Occurs in 3-5% of pregnancies and is more common in older women
Pregnancy-Induced hypertension (PIH or Gestational Hypertension)
- Hypertension (as defined above) occurring in the second half of pregnancy (after 20weeks)
- No proteinuria, No Oedema
- Occurs in around 5 – 7% of pregnancies
- Resolves following birth (typically after a month).
- Women with PIH are increase risk of future pre-eclampsia or hypertension in later life.
- Pregnancy induced hypertension in association with:
- Proteinuria (>0.3g/24hours)
- Oedema may occur but is now less commonly used as a criteria
- Occurs in around 5% of pregnancies.