Table 2

Tests for hypertensive disorders in pregnancy

History

Risk factors e.g. nulliparity, new partner, hypertension on oral contraceptives, pre-existing diabetes, renal disease, chronic hypertension, parity

Examination

Blood pressure (systolic and diastolic and mean arterial pressure), peripheral oedema, body mass index, waist circumference, hip:waist ratio

Investigations

Biochemical

Serum uric acid, urinary calcium excretion, urinary albumin-creatinine and calcium-creatinine ratios, microalbuminuria, fibronectin, spot proteinuria, 24-hour urinary protein levels

Haemodynamic

Pressor response to various forms of stimuli e.g., supine "rollover", isometric exercise, passive tilting, uterine artery Doppler

Haematological

Antithrombin III, platelet count, haemoglobin, haematocrit, fibrinogen

Other tests

Thrombomodulin, endothelin-1, plasminogen activator inhibitor, free fatty acids, atrial natriuretic peptide, angiotensin II infusion, platelet angiotensin II binding site density, öhCG, õFP, fasting insulin levels

Cnossen et al. BMC Pregnancy and Childbirth 2006 6:29   doi:10.1186/1471-2393-6-29