Monitoring during hospital stays for pre-eclampsia

Women we interviewed who stayed in hospital because of pre-eclampsia or HELLP syndrome regularly saw doctors and midwives and had their health closely monitored with different tests and checks.

Most women had been on wards with other patients, many of whom were also being monitored. A few people said talking to the other pregnant women in the shared room was good and helped pass the time. Some even made lasting friendships. Women were closely monitored, especially if they were very poorly and doctors were worried that the situation could become more serious quickly. Paige remembered having one-to-one care where a midwife or doctor stayed in the hospital room with her all the time – ‘even when they were on break I had to have somebody else come in the room; I wasn’t allowed to be left alone’.

Olivia stayed in hospital for a week. She wasn’st given any medicines but she thought rest helped her blood pressure lower. She was discharged but returned to the hospital only a few hours later.

Age at interview 32

Gender Female

Age at diagnosis 28

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Aileen had experience of being on a ward with other patients and in a High Dependency Unit (HDU).

Age at interview 40

Gender Female

Age at diagnosis 35

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Ongoing checks

Doctors and midwives ran different tests and checks. Monitoring helps give a better idea of how serious the situation is and how it is or isn’t changing. Josie stayed in hospital for two weeks and, during this time, she had her blood pressure measured every three hours throughout the day and night, blood tests every two days and ultrasound scans every three or four days.

Paige had tests and various medicines, including some to lower her blood pressure and to help her baby’s lungs develop, when she was admitted to hospital.

Age at interview 20

Gender Female

Age at diagnosis 19

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Hanna was monitored overnight in hospital. She didn’st feel ill but was told by doctors that she was very unwell. She had an ultrasound to check on her baby.

Age at interview 39

Gender Female

Age at diagnosis 37

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Having tests and checks was part of the daily routine in hospital for Emma.

Age at interview 38

Gender Female

Age at diagnosis 34

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Women described various tests:

Checking blood pressure

All the women we spoke to previously had their blood pressure checked at routine antenatal appointments and some had also been self-monitoring at home. Blood pressure was also frequently monitored in hospital so that a fuller picture could be built up of the readings and any worrying readings could be acted on quickly. However, the frequency of blood pressure tests could be exhausting, especially if they were run all day and night. Aileen said the constant monitoring was reassuring but also tiring: ‘obviously I didn’t get a good night’s sleep or a good day’s sleep’.

Testing blood samples

Blood samples were usually taken and tested. Kay remembered having her blood tests taken at 6am every morning in the hospital. It was blood tests that revealed Helen X’s liver was not functioning very well and she was told she had HELLP syndrome.

Testing urine samples and measuring urine output

Urine samples and sometimes urine output (i.e. how much urine a person produces compared to the quantity of liquids they drink) were closely monitored too. Kay had to do both – her ‘first morning sample’ was tested for protein levels and she had a ‘big tub [] to pour my daily amount’ of urine which was measured as well as tested. Some women had restrictions on how much liquids they were allowed to drink each day.

Dominie had her urine output monitored in hospital. She had a catheter fitted at first which she didn’st like and also had her water intake restricted.

Age at interview 25

Gender Female

Age at diagnosis 24

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Ultrasound scans and using a Doppler device

Some checks looked more directly at the health of the unborn babies. These tests including trace monitoring (also known as CTG or cardiotocography) which measures the unborn baby’s heartbeat. This usually involves a kind of belt being strapped around the pregnant woman’s bump, although Angela had one with ‘prongs’ placed on her bump around the baby’s head which she said gave a very accurate reading. In some instances the midwife or doctor used a Doppler, a device moved over a pregnant woman’s bump to check the unborn baby’s heartbeat and the placental blood flow.

Kay had Doppler checks and ultrasounds. It was very worrying that her unborn baby was so small, but she found some comments made by her consultant reassuring.

Age at interview 42

Gender Female

Age at diagnosis 38

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Munirah was admitted to stay in hospital 25 weeks into her pregnancy. Ultrasound scans showed that her unborn baby was very ill and her own health was deteriorating rapidly, so the decision was made to terminate her pregnancy.

Age at interview 27

Gender Female

Age at diagnosis 27

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Frequent monitoring could be reassuring, but it could also feel like a chore. Kay remembered finding it annoying having nurses check on her all the time, but also realised it showed that they were doing their job well. Julie didn’t like the feeling of being ‘strapped to the bed’ by all the monitoring equipment.
Monitoring guided the next steps taken in hospital for women with pre-eclampsia, such as taking medicines. You can also find out more about women’s experiences of being informed and included in decision-making in hospital here.

Treatment in hospital for pre-eclampsia

Of the women we interviewed, there had been different ways that their pre-eclampsia had been managed and treated in hospital. Medicines and treatment in hospital...