Hypertensive disorders of pregnancy

1. Big picture

Hypertensive disorders of pregnancy are among the most important causes of maternal mortality, perinatal mortality, fetal growth restriction, placental abruption, preterm birth, eclampsia, HELLP syndrome, stroke, renal failure, pulmonary edema, and disseminated intravascular coagulation (DIC).

The examiner wants you to think in this order:

Pregnant woman with high blood pressure
        ↓
Is she ≥20 weeks?
        ↓
Is there proteinuria or organ dysfunction?
        ↓
Are there severe features?
        ↓
Is the mother stable?
        ↓
Is the fetus compromised?
        ↓
Stabilize mother → prevent seizure → control BP → decide timing of delivery

Core