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Hypertension in pregnancy - Management
Basis for recommendation
Take a history and assess if investigation for secondary causes is required
- CKS has based these recommendations on accepted clinical practice.
Dipstick urine for proteinuria
- Proteinuria in women with chronic hypertension may be:
- Due to underlying renal disease.
- Due to the development of pre-eclampsia if it is new and occurs after 20 weeks' gestation.
- The National Institute for Health and Clinical Excellence (NICE) recommends the use of automated dipstick testing in secondary care. Evidence from a meta analysis of six trials and a prospective study showed that visual dipstick analysis of urine with a 1+ threshold is not accurate at detecting clinically significant proteinuria. Its use in clinical decision making is therefore limited. Accuracy is improved by using an automated dipstick device. Primary care clinicians should use automated dipsticks if they have access to them.
Assessing for symptoms of pre-eclampsia
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