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25 cze 2019 · This guideline covers diagnosing and managing hypertension (high blood pressure), including pre-eclampsia, during pregnancy, labour and birth. It also includes advice for women with hypertension who wish to conceive and women who have had a pregnancy complicated by hypertension.
•NICE guideline (DG23) PlGF-based testing to help diagnose suspected pre-eclampsia (Triage PlGF test, Elecsys immunoassay sFlt-1/PlGF ratio, DELFIA Xpress PlGF 1-2-3 test, and BRAHMS sFlt-1 Kryptor/BRAHMS PlGF plus Kryptor PE ratio).
The recommendations on management of women at high risk of, or exhibiting clincical featues of pre-eclampsia are largely based on expert opinion in the National Institute of Health and Care Excellence (NICE) guideline Hypertension in pregnancy: diagnosis and management [NICE, 2019b].
Women who develop severe pre-eclampsia and eclampsia. The guidance encompasses the principles within the NICE clinical guidance (NG133) hypertension in pregnancy: diagnosis and management, and NICE Quality Standard number 35 hypertension in pregnancy.
Recommendations for research. As part of the 2019 update, the guideline committee made 6 research recommendations on the management of pregnancy with chronic hypertension, pre-eclampsia, fetal monitoring, the use of antihypertensives in breastfeeding and advice and follow-up.
• NICE states to offer placental growth factor (PlGF)-based testing to help rule out pre-eclampsia- This is not yet available at Barnsley NHS Foundation Trust. • A rise in Creatinine of more than 90 micromol/litre or more is the measurement used in Barnsley. • FullPIERS or PREP-S is not used in Barnsley
•BP measures: QDS whilst I/P, every 1-2 days for up to 2 weeks until woman is off treatment and has no hypertension. • Clincal review: Ask about headaches and epigastric pain at every visit
