Fetal assessment

Early onset pre-eclampsia is particularly involved with placental insufficiency, and more than half of babies born before 34 weeks will be growth restricted [35]. This also explains why abruption is more common, occurring in about 1 in 20 of these early onset cases. Fetal well-being should always be carefully considered in all cases of pre-eclampsia, and includes a symphyseal fundal height assessment, as well as a general enquiry as to fetal movements. At early gestations an ultrasound scan must be performed to assess fetal growth, and should include determination of the amniotic fluid index and umbilical artery Doppler waveforms. A non-reactive CTG with decelerations or a fetal condition that is deteriorating warrants delivery, as it is unlikely to improve with time and may worsen with antihypertensive therapy.

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