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Quick Chart
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
- Primary Survey
- Vital Sign Survey
- Consider Oxygen
- Treat seizure as per CPG
- Secondary / CNS Survey (as required)
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
Document Control
Directorate
Clinical Services
Responsible Manager
Head of Clinical Services
Published Date
Review Date
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