Hypertensive Disorders & Eclampsia
Recognise maternal organ involvement and distinguish pressure control from seizure prevention.
Quick revision ↓ Medical Dictionary
01Classify the disorder
Hypertension may predate pregnancy or first develop during it. Pre-eclampsia involves hypertension with relevant maternal organ or uteroplacental dysfunction and does not always require proteinuria. Assess blood pressure correctly and investigate symptoms, urine and laboratory findings as indicated. A single normal urine dip does not safely exclude a serious hypertensive disorder.
02Warning symptoms
Severe headache, visual disturbance, epigastric or right upper quadrant pain, breathlessness or neurological change needs urgent assessment. Severe hypertension requires prompt treatment through the obstetric pathway. Maternal stability and fetal assessment are considered together, but resuscitating the mother is fundamental to fetal wellbeing.
03Treatment goals
Antihypertensives lower blood pressure, while magnesium sulfate is used for eclamptic seizures and appropriate seizure prophylaxis under specialist protocols. These are different goals. Monitor the patient and relevant toxicity signs during treatment, with doses and antidote arrangements governed by the local protocol. Do not substitute one intervention for the other.
04Timing birth
The decision to deliver depends on gestation, maternal condition, fetal findings and response to treatment. Senior obstetric, anaesthetic and neonatal input may be needed. Stabilisation and planned delivery are coordinated rather than treating birth as a reason to omit urgent maternal care. Explain the rationale and uncertainties to the patient and support person.
05After delivery
Hypertensive disease and seizures can first appear or worsen postpartum. Continue symptom, pressure and laboratory follow-up as indicated. Review medicines for breastfeeding and longer-term use. Explain future pregnancy and cardiovascular risk review, and provide clear instructions for urgent return with headache, visual symptoms, breathlessness or seizures after discharge.
High-Yield Revision
- Proteinuria is not mandatory in every pre-eclampsia diagnosis.
- Pressure control and seizure prevention are separate tasks.
- Disease can present after birth.
Common Pitfalls
- Using a normal urine dip as complete reassurance.
- Stopping surveillance immediately after delivery.
References & Further Reading
Read the relevant guideline sections alongside these original clinical teaching cases. Local pathways, available services and individual patient factors determine care.
Reference review: 28 September 2026. Consult current local protocols for prescribing, procedures and escalation.