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Introduction

Hypertension occurs in 4% of all pregnancies in WA.

Hypertension in pregnancy is defined as;

  • Systolic BP ≥140mmHg and/or diastolic ≥90mmHg
  • Severe hypertension systolic ≥170mmHg and/or diastolic ≥110mmHg

Gestational

  • Hypertension ≥20 weeks gestation

Pre-eclampsia

  • Hypertension ≥20 weeks gestation with one or more signs of organ involvement

Eclampsia

  • Rare condition where hypertension results in seizures
Clinical Presentation
  • Increasing BP
  • Severe headache
  • Visual disturbances – flashing lights
  • Nausea and Vomiting
  • Abdominal pain
  • Hyper-reflexia
  • Convulsions/seizures – eclampsia
  • Increased bleeding/bruising
  • Intrauterine growth restrictions
Exclusion Criteria
Exclusion Criteria
Risk Assessment
  • N/A
Management
Primary Care
Intermediate Care (EMT / Level 2)
  • Apply cardiac monitor if trained and authorised
  • Monitor patient persistently, recording full observations every 10 minutes (or 5 minutes if time critical)
  • Transport Priority 1 if patient time critical, pre-notifying receiving facility
Advanced Care (AP)
  • Apply cardiac monitor
  • Establish vascular access
  • Treat seizures as per CPG
  • Monitor patient persistently, recording full observations every 10 minutes (or 5 minutes if time critical)
  • Transport Priority 1 if patient time critical as per transport decision guidelines, pre-notifying receiving facility
Transport Decision
  • < 20 weeks – nearest/allocated ED
  • ≥ 20 weeks – obstetric unit
  • ALL pregnant patients suffering major trauma, follow Major Trauma Guideline
Critical & Extended Care (CCP, PSO)
  • As per Advanced Care (AP) guidelines
Additional Information
  • Liaise with obstetrics units in the metropolitan area, recording all advise given on ePCR
  • Liaise with local hospitals in country areas, recording all advice given on ePCR

References
References
Key Terms & Links
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Directorate
Clinical Services

Responsible Manager
Head of Clinical Services

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