15th July 2024

Management

Women at high risk for pre-eclampsia, including women with chronic kidney disease, should start prophylactic aspirin (75-150mg) from 12 weeks’ gestation, reducing the risk of developing pre-eclampsia by 10%. Early detection of adverse foetal outcomes is monitored through increased frequency of antenatal scanning and obstetric clinics. Pre-eclamptic mothers should also monitor their blood pressures at home with pharmacological treatment started for blood pressure consistently 140/90mmHg or above. Renal and liver function tests should be measured two to three times per week, depending on the severity of hypertension.

Severe hypertension (>/=160/110 mmHg) should be treated in hospital under close obstetric monitoring and agents include oral nifedipine, methyldopa or oral/intravenous labetalol. Ultimately, timely delivery of the baby is the only curative management, balancing gestation for optimal in-utero development with maternal outcomes. Birth before 37 weeks is not indicated if blood pressure remains lower than 160/110 mmHg.