What criteria should I use to refer a pregnant patient with suspected pre-eclampsia to secondary care?

Arrange secondary care assessment within 24 hours by a healthcare professional trained in the management of hypertensive disorders of pregnancy for all women with new onset of hypertension (over 140 mmHg systolic or over 90 mmHg diastolic) after 20 weeks of pregnancy ¹.

Arrange emergency secondary care assessment for any women in whom pre-eclampsia is suspected ¹.

Women with severe hypertension (blood pressure of 160/110 mmHg or more) should be admitted to hospital for ongoing monitoring and management ¹.

Women with new-onset severe hypertension or signs of severe pre-eclampsia, such as ongoing or recurring severe headaches, visual disturbances, epigastric pain, oliguria, or deterioration in blood tests, should be referred for secondary care assessment ².

Women with abnormal blood test results or clinical signs indicating concern, such as rising creatinine, liver transaminases, falling platelet count, or signs of fetal compromise, should be referred ².