This course is part of the RCOG Core Knowledge series.
Pre-eclampsia is defined by the International Society for the Study of Hypertension in Pregnancy as gestational hypertension of at least 140/90 mmHg on two separate occasions ≥4 hours apart accompanied by significant proteinuria of at least 300 mg in a 24-hour collection of urine, arising de novo after the 20th week of gestation in a previously normotensive woman and resolving completely by the 6th postpartum week.
This hypertensive condition usually occurs during the second half of pregnancy, complicating 2–8% of pregnancies. Pre-eclampsia is a major cause of maternal and perinatal mortality and morbidity worldwide causing 15% of all direct maternal deaths in the UK and a fivefold increase in perinatal mortality with iatrogenic prematurity being the main culprit. The World Health Organization estimates that, worldwide, approximately 70 000 women die from pre-eclampsia each year. The Confidential Enquiry into Stillbirths and Deaths in Infancy (CESDI) report cites one in six stillbirths as occurring in pregnancies complicated by maternal hypertension (note that the Confidential Enquiry into Maternal and Child Health [CEMACH] was established in April 2003, and replaces the CESDI).
Pre-eclampsia is a heterogeneous, multi-systemic disorder, which presents with varying degrees of severity. In general, maternal and perinatal outcomes are usually favourable when mild pre-eclampsia develops after 36 weeks of pregnancy. The risk of serious maternal and perinatal morbidity and mortality increases significantly when pre-eclampsia develops prior to 33 weeks pregnant, in those with pre-existing medical conditions and in those from under-resourced countries. As pre-eclampsia is associated with significant maternal and perinatal morbidity and mortality, it is imperative that every effort is made to accurately classify women with hypertension in pregnancy as having chronic hypertension, non-proteinuric pregnancy-induced hypertension (PIH) or pre-eclampsia, as the aetiology and management of the three conditions is very different.
This course should be read in conjunction with the Intrapartum management of pre-eclampsia tutorial in Management of Labour and Birth.
When you have completed this course you will be able to:
- classify and diagnose hypertensive disorders of pregnancy
- describe the maternal and fetal complications that occur as a result of hypertensive disorders in pregnancy
- demonstrate knowledge of the underlying aetiology and pathophysiology of pre-eclampsia
- demonstrate competence in the antenatal, intrapartum and postnatal management of pre-eclampsia
- discuss the limitations of screening and prevention of pre-eclampsia
Dr Fergus McCarthy MRCOG (2007, 2014, 2016, 2019)
Fergus McCarthy is a Consultant in Obstetrics and Gynaecology, Maternal Fetal Medicine Subspecialist and Senior Lecturer at Cork University Maternity Hospital and the Irish Centre for Fetal and Neonatal Translational research (INFANT) at University College Cork, Ireland. His PhD investigated the aetiology of, and potential therapeutic targets in the treatment of pre-eclampsia. His current research focus is on the long-term cardiovascular implications of pre-eclampsia and hypertensive dsorders of pregnancy.
Professor Louise Kenny PhD MRCOG (2007, 2014, 2016, 2019)
Louise Kenny is the Executive Pro Vice Chancellor of the Faculty of Health and Life Sciences at the University of Liverpool. She is founding Director of the Irish Centre for Fetal and Neonatal Translational Research (INFANT www.infantcentre.ie) and was until December 2017 Professor of Obstetrics and Gynaecology at Cork University Maternity Hospital where she worked as a Consultant Obstetrician and Gynaecologist from 2006-2018. Professor Kenny has a longstanding clinical and research interest in hypertensive disorders of pregnancy.
The content of this course relates to the following Capabilities in Practice (CiPs) and key skills:
CiP 1: Clinical skills and patient care
All
CiP 2: Working in health organisations
Adheres to legal
Professional requirements
Understands ethical principles
Working in a digital environment
CiP 5: Human factors
Demonstrates insight into decision making
Team working
CiP 6: Developing self & others
Commits to continued learning
Develops people
CiP 8: Educator
Effective teaching
CiP 10: Emergency obstetrics
Manages concerns about fetal wellbeing
Manages labour
Manages intrapartum fetal surveillance
Manages induction, augmentation of labour
Manages emergency birth, postpartum problems
Manages maternal collapse
Manages labour ward
CiP 12: Non-emergency obstetrics
Manages pre-existing medical conditions in the pregnant woman
Manages conditions arising in pregnancy
Manages fetal concerns
Supports antenatal decision making
Manages a postnatal consultation
CiP 14: Health promotion
Understands impact of policy
Further details about each CiP can be found within the O&G Core Curriculum 2024 Definitive Document, available here.
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Pre-eclampsia - 12 Month Access
£50.40
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