Table 2.

Actions to be taken by midwife or general practitioner when women present with signs and symptoms

Definition	Action by midwife or general practitioner
New hypertension without proteinuria (grade C)
Blood pressure:
Diastolic ≥90 and <100 mm Hg	Refer for hospital step-up assessment within 48 hours
Diastolic ≥90 and <100 mm Hg with any symptom from box 4	Refer for same day hospital step-up assessment
Systolic ≥160 mm Hg	Refer for same day hospital step-up assessment
Diastolic ≥100 mm Hg	Refer for same day hospital step-up assessment
New hypertension with proteinuria (grade A)
Blood pressure:
Diastolic ≥90 mm Hg and new proteinuria ≥+ on dipstick	Refer for same day hospital step-up assessment
Diastolic ≥110 mm Hg and new proteinuria ≥+ on dipstick	Arrange immediate admission
Systolic ≥170 mm Hg and new proteinuria ≥+ on dipstick	Arrange immediate admission
Diastolic ≥90 mm Hg and new proteinuria ≥+ on dipstick and any symptom from box 4	Arrange immediate admission
New proteinuria without hypertension (grade C)
Reading on dipstick:
+	Repeat pre-eclampsia assessment in community within one week
≥++	Refer for hospital step-up assessment within 48 hours
≥+ with any symptom from box 4	Refer for same day hospital step-up assessment
Maternal symptoms or fetal signs and symptoms without hypertension or proteinuria (grade C)
Symptoms along with diastolic blood pressure <90 mm Hg and trace or no protein:
Headache, visual disturbances, or both	Follow local protocols for investigation. Consider reducing interval before next PRECOG assessment
Epigastric pain	Refer for same day hospital step-up assessment
Reduced movements or small for gestational age infant	Follow local protocols for investigation. Consider reducing interval before next full pre-eclampsia assessment

PRECOG=Pre-eclampsia community guideline.