ABSTRACT
This chapter presents a case study of a 35-year-old black lady who is suffering with a headache. It is highly likely that this patient has pre-eclampsia and must be investigated and managed promptly. Pre-eclampsia is a multi-system disorder characterised by pregnancy-induced hypertension occurring after 20-week gestation and significant proteinuria. This patient has severe pre-eclampsia and must be treated urgently. Labetalol given either orally or intravenously is usually first line. Oral nifedipine and intravenous hydralazine can also be used for acute management. Atenolol, angiotension-converting-enzyme inhibitors and angiotension-receptor blockers should be avoided antenatally. Fluid restriction is advised to reduce the risk of pulmonary oedema. This patient will require urgent transfer to the High Dependency Unit or labour ward for stabilising and monitoring as she is at risk of an eclamptic fit. In cases of uncontrollable blood pressure or eclampsia, delivery of the fetus via an emergency caesarean section may be required.
