What monitoring protocols should be followed for a patient with pre-eclampsia to prevent complications?

Monitor blood pressure regularly: Measure blood pressure hourly during labour in women with hypertension, and every 15 to 30 minutes until blood pressure is less than 160/110 mmHg in women with severe hypertension ¹.

Assess maternal laboratory parameters: Measure platelet count, transaminases, and serum creatinine 48 to 72 hours after birth or step-down from critical care, and repeat if results are abnormal ².

Urinary protein monitoring: Carry out a urinary reagent-strip test 6 to 8 weeks after birth, and if proteinuria persists (1+ or more), arrange further review at 3 months to assess kidney function ².

Fetal monitoring: Carry out ultrasound for fetal growth, amniotic fluid volume, and umbilical artery doppler velocimetry at diagnosis, and repeat every 2 to 4 weeks if normal, or as clinically indicated in pre-eclampsia or severe gestational hypertension ².

Cardiotocography (CTG): Perform CTG at diagnosis of pre-eclampsia or severe gestational hypertension, and repeat if there are changes in fetal movement, vaginal bleeding, abdominal pain, or maternal condition deterioration ².

Develop a comprehensive care plan: Include timing and nature of fetal monitoring, indications for birth, antenatal corticosteroids, and plans for multidisciplinary discussion ².