Guideline Summary

Pregnancy induced hypertension (PIH) is a generic term used to define a significant rise in blood pressure during pregnancy after 20 weeks. Pre-eclampsia is diagnosed as an increase in blood pressure (BP) (above 140/90mmHg), oedema and detection of protein in the patient’s urine and is more common in first pregnancies, multiple pregnancies, with pre-existing hypertension, diabetes or renal disease. Severe pre-eclampsia is a multi-organ disease and complications include, intracranial haemorrhage and stroke, renal failure, liver failure, abnormal blood clotting (e.g. disseminated intravascular coagulation), although hypertension is a cardinal feature. Severe pre-eclampsia is diagnosed as a significantly raised blood pressure (i.e. 160/110mmHg) with proteinuria and often one or more of the following symptoms:
 1. headache – severe and frontal
 2. visual disturbances
 3. epigastric pain – often mistaken for heartburn
 4. right-sided upper abdominal pain – due to stretching of the liver capsule
 5. muscle twitching or tremor
 6. other symptoms – nausea, vomiting, confusion.

This guideline provides guidance for paramedics¹ for the assessment and management of pregnancy induced hypertension including eclampsia.

¹The principles will be applicable to all pre-hospital clinicians.

Current guideline - issued 2006