20th June 2026

Diagnosis and investigations

Table 6. Investigations for gestational hypertension

Investigation	Notes
Blood pressure measurement	Measure with the woman in a seated position Measure at least twice, 4 hours apart. The mean of the two readings is used to diagnose GH
Urine protein	Collect a midstream urine sample for dipstick analysis If proteinuria is detected, a 24-hour urine collection should be performed to quantify the amount of protein secreted
FBC	Anaemia can exacerbate hypertension Thrombocytopaenia is a potential complication of pre-eclampsia
LFTs	Hepatic dysfunction is a potential complication of pre-eclampsia Elevated liver enzymes may prompt further investigations
Renal function tests	Renal impairment is a potential complication of pre-eclampsia
Coagulation studies	Coagulopathy is a potential complication of pre-eclampsia
Foetal surveillance, e.g. assessing foetal movement or biophysical profile testing	Concerns about foetal well-being may prompt further investigations, such as umbilical artery doppler or foetal ultrasound
Other	ECG for cardiac abnormalities CXR for pulmonary oedema Cranial imaging for cerebral haemorrhage or infarction Measurement of placental growth factor (PIGF): may reduce the delay in diagnosing pre-eclampsia

Severity classification of gestational hypertension:

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