19.2.1 Classification of pre-eclampsia
Pre-eclampsia is the commonest type of hypertensive disorder of pregnancy and the focus of much of the discussion in this section (see Table 19.2). It usually occurs in the second half of pregnancy (after 20 weeks of gestation, but most commonly after 28 weeks). The appearance of protein in the woman’s urine (proteinuria) is a danger sign. Significant proteinura is defined as a positive urine dipstick test for protein with a result greater than or equal to +2 on the scale supplied with the dipsticks.
Proteinuria is pronounced ‘proh-teen-you-ree-ah’.
You will learn about these symptoms of severity in Section 19.4 later.
| Type | Raised blood pressure (measured twice, 6 hours apart) | Proteinuria | Symptoms of severity |
|---|---|---|---|
| Gestational hypertension (develops during pregnancy, resolves afterwards) | Above 140/90 mmHg | No significant proteinuria | None |
| Mild pre-eclampsia | Between 140/90 and 160/110 mmHg | No significant proteinuria | None |
| Severe pre-eclampsia | Greater than or equal to 160/110 mmHg | With or without significant proteinura (urine dipstick test result greater than or equal to +2) | Headache, blurred vision, epigastric burning pain, decreased urine output, decreased or absent fetal kick |
| Superimposed pre-eclampsia | Higher than before the pregnancy in a known chronic hypertensive woman | Significant or worsening proteinuria | With or without symptoms of severity |
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19.2 Classification of hypertension during pregnancy