Clinician diagnosis of pre-eclampsia, based on the ISSHP definition: a blood pressure ≥140/90mmHg AND either:
1. Significant proteinuria (protein/creatinine ratio (PCR) of 30 mg/mmol or more) OR
2. Maternal multiorgan dysfunction:
a. Acute kidney injury (AKI) (creatinine ≥90 μmol/L)
b. Liver involvement (elevated transaminases e.g. alanine transaminase (ALT) or aspartate transaminase (AST) >40IU/L) with or without right upper quadrant or epigastric abdominal pain)
c. Neurological complications (including eclampsia, altered mental status, blindness, stroke, clonus, severe headaches, persistent visual scotomata)
d. Haematological complications (thrombocytopenia – platelet count below 150,000/μL, DIC, haemolysis) OR
3. Uteroplacental insufficiency (fetal growth restriction, abnormal Umbilical artery doppler, stillbirth)
developing at or after 20 weeks gestation.
- For the woman: death, eclampsia, stroke, HELLP syndrome, cortical blindness, pulmonary oedema, acute kidney injury, liver capsule haematoma, abruption, postpartum haemorrhage, ITU admission, intubation, mechanical ventilation, gestational and severe hypertension, early onset pre-eclampsia <34 weeks, need for elective delivery, mode of delivery, composite morbidity, adverse effects.
- For the baby: death before hospital discharge, gestational age at delivery, birthweight, small for gestational age, admission to neonatal unit and level of care, number of admission days, neonatal brain injury syndromes, respiratory support, preterm birth <34 and <37 weeks, chronic lung disease, necrotising enterocolitis, intraventricular haemorrhage, retinopathy of prematurity, and composite neonatal morbidity/mortality.
- Adherence to calcium.
- Health economics analyses.