Lesson 1Choosing and citing guidelines: how to find and interpret major guidelines (e.g., ACOG, FIGO, WHO, SOGC, NICE) and selecting recommendations relevant to resource‑limited settingsThis section teaches how to locate, appraise, and apply major guidelines on hypertensive disorders in pregnancy, including ACOG, FIGO, WHO, SOGC, and NICE, and how to adapt recommendations to local resources and patient preferences.
Finding reputable guideline sourcesUnderstanding guideline strength of evidenceComparing ACOG, FIGO, WHO, SOGC, NICEAdapting guidance to limited resourcesReconciling conflicting recommendationsDocumenting and citing guideline useLesson 2Clinical history and risk factor assessment: prior obstetric history, antenatal visit gaps, symptoms (headache, visual changes, epigastric pain), medication and social factorsThis section details how to obtain a focused clinical history for suspected hypertensive disorders, including prior pregnancies, gaps in antenatal care, key warning symptoms, medications, and social determinants that modify risk and influence follow‑up.
Key elements of prior obstetric historyDocumenting antenatal care gaps and delaysEliciting headache and visual symptomsAssessing epigastric or right upper quadrant painMedication review, including herbal productsSocial, nutritional, and substance use factorsLesson 3Urine and protein assessment: dipstick limitations, spot urine protein:creatinine ratio, 24‑hour urine protein indications and interpretationThis section explains methods for assessing proteinuria in pregnancy, highlighting dipstick limitations, indications for spot protein–creatinine ratio and 24‑hour urine, how to interpret results, and how timing and collection errors affect accuracy.
Proper midstream urine collection stepsDipstick testing limits and false resultsSpot protein–creatinine ratio indicationsInterpreting protein–creatinine ratio valuesWhen to order 24‑hour urine collectionCommon errors in 24‑hour urine samplingLesson 4Blood pressure measurement technique and interpretation: clinic repeat measurements, ambulatory/home monitoring principles, thresholds for diagnosisThis section reviews correct blood pressure technique in pregnancy, including cuff selection, positioning, timing, repeat readings, and interpretation of clinic and home values, with diagnostic thresholds and common pitfalls that can misclassify disease.
Preparing the patient and resting periodCorrect cuff size and arm positioningKorotkoff sounds and reading diastolic BPRepeat measurements and averaging valuesHome and ambulatory BP monitoring basicsDiagnostic thresholds and white‑coat effectLesson 5Differential diagnoses for hypertension and proteinuria in pregnancy: urinary tract infection, renal disease, molar pregnancy, acute fatty liver, thrombocytopenia causesThis section reviews key differential diagnoses for hypertension and proteinuria in pregnancy, including urinary tract infection, chronic or acute renal disease, molar pregnancy, acute fatty liver, and major causes of thrombocytopenia that can mimic preeclampsia.
Distinguishing chronic kidney diseaseUrinary tract infection with hypertensionFeatures of molar pregnancy and GTDAcute fatty liver versus HELLP syndromeImmune and nonimmune thrombocytopeniaOther secondary causes of hypertensionLesson 6Targeted imaging: role and indications for obstetric ultrasound (fetal growth, amniotic fluid, placental assessment) and Doppler studiesThis section explains when and how to use targeted imaging in hypertensive pregnancy, focusing on obstetric ultrasound for fetal growth, amniotic fluid, and placenta, and Doppler studies to assess uteroplacental and fetal circulation and guide timing of delivery.
Indications for obstetric ultrasoundAssessing fetal growth and biometryEvaluating amniotic fluid volumePlacental location and morphologyUterine and umbilical artery DopplersUsing imaging to guide delivery timingLesson 7Initial bedside and lab tests to confirm diagnosis: CBC, platelets, liver enzymes (AST/ALT), serum creatinine, uric acid, electrolytes, coagulation tests, blood type and antibody screenThis section covers essential bedside and laboratory tests used to confirm and stage hypertensive disorders, including CBC, platelets, liver enzymes, creatinine, uric acid, electrolytes, coagulation profile, and blood type with antibody screen, plus basic interpretation.
Bedside assessments and vital sign reviewCBC and platelet count interpretationLiver enzymes and hepatic involvementSerum creatinine and kidney function testsUric acid and electrolyte abnormalitiesCoagulation tests and blood type screeningLesson 8Pathophysiology and classification: chronic hypertension, gestational hypertension, preeclampsia with/without severe features, eclampsia, HELLP syndromeThis section outlines the pathophysiology of hypertensive disorders in pregnancy and clarifies diagnostic criteria for chronic hypertension, gestational hypertension, preeclampsia with or without severe features, eclampsia, and HELLP, emphasizing clinical implications.
Normal cardiovascular changes in pregnancyAbnormal placentation and endothelial injuryDefining chronic versus gestational hypertensionDiagnostic criteria for preeclampsiaSevere features and eclampsia recognitionDiagnostic features of HELLP syndrome
