The blood pressure should be checked each 15 minutes until the woman is stabilised and then every 30 minutes in the initial phase of assessment.

The blood pressure should be checked 4-hourly if a conservative management plan is in place and the woman is stable and asymptomatic.

Assessment of the woman requires a full blood count, liver function and renal function tests. These should be repeated at least daily when the results are normal but more often if the clinical condition changes or if there are abnormalities.

Clotting studies are not required if the platelet count is over 100 x 106/l.

Close fluid balance with charting of input and output is essential. A catheter with an hourly urometer is advisable in the acute situation, especially in the immediate postpartum period.

In pre-eclampsia, there can be a rise in uric acid that correlates with poorer outcome for both mother and baby.⁹⁹⁰² This rise confirms the diagnosis of pre-eclampsia and confers an increased risk to the mother and baby but the levels,in themselves, should not be used for clinical decision-making. Renal function is generally maintained in pre-eclampsia until the late stage unless HELLP syndrome develops.^{8201, 9903}If creatinine is found to be elevated early in the disease process, underlying renal disease should be suspected. In severe disease, serum creatinine can be seen to rise and is associated with a worsening outcome⁹⁹⁰³ but renal failure is now uncommon in pre-eclampsia in the developed world and when it does occur it is usually associated with haemorrhage, HELLP syndrome or sepsis.

A falling platelet count is associated with worsening disease and is itself a risk to the mother.⁷⁸⁰¹ However, it is not until the count is less than 100 x 106/l that there may be an associated coagulation abnormality.⁹⁹⁰⁴ Other parameters, such as platelet volume, may be of benefit but are as yet unproven. A platelet count of less than 100 should be a consideration for delivery. An AST level of above 75 iu/l is seen as significant and a level above 150 iu/l is associated with increased morbidity to the mother. A diagnosis of HELLP syndrome needs confirmation of haemolysis, either by LDH levels, as commonly assessed in the USA, or by blood film to look for fragmented red cells. An AST or ALT level of above 70 iu/l is seen as significant and a level above 150 iu/l is associated with increased morbidity to the mother.13 The platelet count would have to be below 100 x 106 to support the diagnosis.