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 part teaches how to find, check, and use big guidelines on high blood pressure in pregnancy, like ACOG, FIGO, WHO, SOGC, and NICE, and how to adjust advice to fit local resources and what patients prefer in places like Zambia.
Finding trusted guideline sourcesUnderstanding strength of evidence in guidelinesComparing 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 part details how to get a focused patient history for suspected high blood pressure issues, including past pregnancies, missed antenatal visits, main warning signs, medicines, and social factors that change risk and affect follow-up in Zambian communities.
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 part explains ways to check for protein in urine during pregnancy, pointing out limits of dipstick tests, when to use spot protein-creatinine ratio and 24-hour urine, how to read results, and how mistakes in timing and collection affect accuracy in busy Zambian facilities.
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 part reviews right ways to measure blood pressure in pregnancy, including choosing cuffs, positioning, timing, repeat checks, and reading clinic and home values, with diagnosis levels and common errors that can wrongly label the condition in Zambian settings.
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 part reviews main other possible causes for high blood pressure and protein in urine during pregnancy, like urine infections, ongoing or sudden kidney problems, molar pregnancy, sudden fatty liver, and big reasons for low platelets that can look like preeclampsia in Zambian patients.
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 part explains when and how to use special scans in high blood pressure pregnancies, focusing on pregnancy ultrasound for baby growth, fluid around baby, and placenta, and Doppler to check blood flow to placenta and baby to help decide when to deliver in resource-limited Zambian areas.
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 part covers key bedside and lab tests to confirm and stage high blood pressure disorders, including full blood count, platelets, liver tests, creatinine, uric acid, salts, clotting profile, and blood group with antibody check, plus simple reading of results for Zambian practitioners.
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 part outlines how high blood pressure disorders in pregnancy develop and clears up diagnosis rules for ongoing high blood pressure, pregnancy-only high blood pressure, preeclampsia with or without bad signs, fits from it, and HELLP, stressing what it means for care in Zambia.
Normal cardiovascular changes in pregnancyAbnormal placentation and endothelial injuryDefining chronic versus gestational hypertensionDiagnostic criteria for preeclampsiaSevere features and eclampsia recognitionDiagnostic features of HELLP syndrome
