Importance of Screening in Pregnancy for Pre-Eclampsia and Proteinuria

NICE have issued new guidance highlighting the importance of measuring high blood pressureThe pressure of blood within the arteries. in pregnant women. This follows news earlier in the year that compared the safety of child birth in different countries and pointed out that it was more dangerous to give birth in the United States than it was in Beirut, mostly due to the dangers of undetected and untreated high bloodA fluid that transports oxygen and other substances through the body, made up of blood cells suspended in a liquid. pressure (hypertensionHigh blood pressure.) and pre-eclampsiaA condition of pregnancy associated with high blood pressure and protein in the urine (proteinuria)..

About hypertension

Hypertension includes the following conditions: Chronic hypertension. Hypertension that is present at the booking visit or before 20 weeks or if the woman is already taking antihypertensive medication when referred to maternity services. It can be primary or secondary in aetiology (i.e. there in the first place, or subsequent to becoming pregnant). Gestational hypertension. New hypertension presenting after 20 weeks without significant proteinuriaProtein in the urine.. Pre-eclampsia. New hypertension presenting after 20 weeks with significant proteinuria Severe pre-eclampsia. Pre-eclampsia with severe hypertension and/or with symptoms, and/or biochemical and/or haematological impairment. Eclampsia. A convulsive condition associated with pre-eclampsia. HELLP syndrome. Haemolysis, elevated liverA large abdominal organ that has many important roles including the production of bile and clotting factors, detoxification, and the metabolism of proteins, carbohydrates and fats. enzymes and low plateletStructure in the blood that helps the blood to clot. count. Significant proteinuria. This is when the urinary protein:creatinineA product of the breakdown of creatine in muscle (creatine itself is fromed from the breakdown of protein). ratio is greater than 30 mg/mmol or a validated 24-hour urine collection result shows greater than 300 mg protein. In addition, the guideline also defines mild, moderate and severe hypertension as: Mild hypertension - diastolic blood pressure 90–99 mmHg, systolic blood pressure 140–149 mmHg. Moderate hypertension - diastolic blood pressure 100–109 mmHg, systolic blood pressure 150–159 mmHg. Severe hypertension - diastolic blood pressure 110 mmHg or greater, systolic blood pressure 160 mmHg or greater. There are a number of factors which increase the risk of hypertension during pregnancythe period from conception to birth. These are categorised into moderate and high risk factors. Moderate risk factors include:

• A first pregnancy
• Older mothers-to-be (aged over 40 years)
• A Body Mass Index (BMI) over 35 at first antenatal visit
• A family history of pre-eclampsia
• Multiple pregnancy

Women at high risk of developing hypertension may have been previously diagnosed with hypertension during an earlier pregnancy or have a condition which may cause hypertension, such as chronicA disease of long duration generally involving slow changes. renalRelating to the kidney. disease or diabetesA disorder caused by insufficient or absent production of the hormone insulin by the pancreas, or because the tissues are resistant to the effects.. Celebrities who have experienced a form of hypertension while pregnant include Sophie Ellis-Bextor, Melinda Messenger, Jane Seymour and Darcey Bussell CBE. They all developed pre-eclampsia during at least one of their pregnancies.