- Episode Written By : Kyla Freeman, FM PGY3
- Episode Reviewed By : Dr. Vanessa Poliquin, OBGYN
- Hosts : Kyla Freeman (FMR3) & Patricia Massel (MD-CCFP)
- Artwork : Aikansha Chawla MS4
In this episode we dive into the hypertensive diseases of pregnancy. We will review the various hypertensive disorders, but our main focus will be on preeclampsia. We will go over screening, ASA starts, and calcium supplementation. We review the clinical presentation and diagnosis of preeclampsia with a nod to HELLP syndrome (see our Liver Disease episode for more on that one!). Finally we will discuss the first steps in management and some post-partum considerations. We hope you enjoy!
California Maternal Quality Care Collective Hypertensive Disorders of Pregnancy Toolkit
- Great resource with all kinds of tables and emergency response algorithms.
- Have to sign up to access – but it’s FREE
SOGC Hypertensive Disorders of Pregnancy Guideline No. 426
- Excellent resource with concise tables for medication dosing and identifying the severe features of preeclampsia.
Calculator to help determine preeclampsia Risk
Patient & Provider Resources @ Preeclampsia.org
- Spanish resources available on this website
- Has a section directed at healthcare providers for up to date information
- August P, Sibai BM. Preeclampsia: Clinical features and diagnosis. Eds. Lockwood CJ, Barss VA. UpToDate. https://www.uptodate.com/contents/preeclampsia-clinical-features-and-diagnosis?search=preeclampsia&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1#H34. Last updated January, 2023.
- August P, Jeyabalan A. Preeclampsia : Prevention. Eds. Lockwood CJ, Barss VA. UpToDate. https://www.uptodate.com/contents/preeclampsia-prevention?search=preeclampsia&topicRef=6814&source=see_link. Last updated Jan 3, 2023.
- August P. Treatment of hypertension in pregnant and post-partum patients. Weds Lockwood CJ, Bakris GL, Barss VA. UpToDate. https://www.uptodate.com/contents/treatment-of-hypertension-in-pregnant-and-postpartum-patients?sectionName=Our%20approach&search=preeclampsia&topicRef=6825&anchor=H2742750444&source=see_link#H2742750444. Last updated November 2022.
- California Maternal Quality Care Collaborative [CMQCC]. Hypertensive disorders of pregnancy toolkit. https://www.cmqcc.org/resources-tool-kits/toolkits/HDP. Last updated 2021.
- Lee M, Guinn D. Antenatal corticosteroid therapy for reduction of neonatal respiratory morbidity and mortality from preterm delivery. Eds. Lockwood CJ, Martin R. Barss VA. UpToDate. https://www.uptodate.com/contents/antenatal-corticosteroid-therapy-for-reduction-of-neonatal-respiratory-morbidity-and-mortality-from-preterm-delivery?search=steroids%20for%20fetal%20lung%20maturity%20&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1. Last updated October 2022.
- Magee LA, Smith GN, Bloch C, Cote A, Jain V, Nerenberg K, von Dadeszen P, Helewa M, Rey E. Guideline No. 426 : Hypertensive disorders of pregnancy: Diagnosis, prediction, prevention, and management. JOGC. 2022; 44(5):547-571. https://doi.org/10.1016/j.jogc.2022.03.002
- Mari G. Fetal growth restriction : Evaluation. Eds. Lockwood CJ, Barss VA. UpToDate. https://www.uptodate.com/contents/fetal-growth-restriction-evaluation. Last updated Decemebr 2022.
- Norwitz ER. Preeclampsia: Antepartum management and timing of delivery. Eds. Lockrood CJ, Barss VA. UpToDate. https://www.uptodate.com/contents/preeclampsia-antepartum-management-and-timing-of-delivery?search=preeclampsia&source=search_result&selectedTitle=2~150&usage_type=default&display_rank=2. Last updated August 2022.
- Norwitz ER, Bellussi F. Early pregnancy prediction of preeclampsia. Eds. Lockwood CJ, Barss VA. UpToDate. https://www.uptodate.com/contents/early-pregnancy-prediction-of-preeclampsia?search=preeclampsia&topicRef=6814&source=see_link. Last updated June 2022.
- Norwitz ER. Preeclampsia : Intrapartum and postpartum management and long-term prognosis. Eds. Lockwood CJ, Barss VA. UpToDate. https://www.uptodate.com/contents/preeclampsia-intrapartum-and-postpartum-management-and-long-term-prognosis?search=preeclampsia&source=search_result&selectedTitle=3~150&usage_type=default&display_rank=3. Last updated Nov 2, 2022.
- Rabi DM, McBrien KA, Sapir-Pichhadze R, Nakhla M, Ahmed SB, Dumanski SM, et al. Hypertension Canada’s 2020 comprehensive guidelines for the prevention, diagnosis, risk assessment, and treatment of hypertension in adults and children. Can. J. Cardiol. 2020;36(5):596-624. Accessed via Hypertension Canada Website February 1, 2023. https://guidelines.hypertension.ca/diagnosis-assessment/supplementary-tables/#suptbl1b
- Society of Obstetricians and Gynecologists of Canada [SOGC]. Hypertensive Disorders of Pregnancy. In: Course manual: Advances in labour and risk management. 27th ed. Canada. SOGC; 2020-2021: 382-418.
- Thandhani RI, Maynard S. Evaluation of proteinuria in pregnancy and management of nephrotic syndrome. Eds Glassock RJ, Barss VA, Lam AQ. UpToDate. https://www.uptodate.com/contents/evaluation-of-proteinuria-in-pregnancy-and-management-of-nephrotic-syndrome?search=preeclampsia&topicRef=6814&source=see_link. Last updated August 2021.
- Yaphe, J, Atzema, C, Helman, A. Hypertensive Emergencies. Emergency Medicine Cases. February, 2014. https://emergencymedicinecases.com/episode-41-hypertensive-emergencies/. Accessed Feb 1, 2023.