Pre-eclampsia: screening, prophylaxis and management
A complete document covering first-trimester risk assessment through to timing of delivery, including aspirin prophylaxis and the use of magnesium sulphate.
Key recommendations
- Combined screening at 11–13+6 weeks to identify high risk
- Aspirin 150 mg at night, from week 12 to week 36
- Magnesium sulphate for eclampsia prophylaxis when severe features are present
- Delivery at 37 weeks without severe features; from 34 weeks in severe disease
Pre-eclampsia remains one of the leading causes of maternal morbidity and mortality. This document brings together recommendations on screening, prophylaxis, diagnosis and management.
Risk assessment
Every pregnant patient should have a history-based risk assessment at the first visit. Aspirin prophylaxis is indicated where one major or two minor risk factors are present.
Monitoring
Once diagnosed, blood pressure, laboratory markers and fetal wellbeing require regular assessment. The frequency of monitoring is determined by whether severe features are present.
Postpartum care
Blood pressure control should continue for at least six weeks. Patients must be given information about the symptoms of late-onset pre-eclampsia.