Last reviewed 01/2018

  • hypertensive disorders during pregnancy may also result in substantial maternal morbidity (1)
    • a study from one region of the UK reported that 1 in 20 (5%) women with severe pre-eclampsia or eclampsia were admitted to intensive care

  • hypertensive disorders also carry a risk for the baby (1)
    • the most recent UK perinatal mortality report, 1 in 20 (5%) stillbirths in infants without congenital abnormality occurred in women with pre-eclampsia
    • the contribution of pre-eclampsia to the overall preterm birth rate is substantial;
      • 1 in 250 (0.4%) women in their first pregnancy will give birth before 34 weeks as a consequence of pre-eclampsia and 8-10% of all preterm births result from hypertensive disorders
      • half of women with severe pre-eclampsia give birth preterm
      • small-for-gestational-age babies (mainly because of fetal growth restriction arising from placental disease) are common, with 20-25% of preterm births and 14-19% of term births in women with pre-eclampsia being less than the tenth centile of birth weight for gestation

Several crises may occur in untreated pre-eclampsia such as:

  • eclampsia
  • cerebral haemorrhage
  • cortical blindness
  • liver failure - such as hepatic rupture
  • renal failure - such as acute renal tubular and/or cortical rupture
  • DIC
  • pulmonary oedema
  • laryngeal oedema
  • abruptio placentae
  • maternal death - this may be the result of any one or more of the above; but death may also be due to failure of coagulation

The risk of fetal death is proportional to the severity of the condition and rises to about 50% if the patient is eclamptic. Pre-eclampsia is a common cause of asymmetrical intra-uterine growth retardation.

Possible causes of fetal death include:

  • hypoxia
  • placental separation
  • immaturity following premature delivery