Hypertension in Pregnancy

Question 1

Hypertension in Pregnancy Complications

Answer 1

Mother
-Second leading cause of maternal deaths in the UK
-Abruptio placentae 
-Cerebrovascular accident
-DIC
Foetus
-Intrauterine growth restriction
-Prematurity
-Intrauterine death

Question 2

Hypertension in Pregnancy Classification

Answer 2

Gestational

• Hypertension after 20 weeks gestation, may be transient or chronic; pre-eclampsia, eclampsia
• Pre-existing hypertension

Question 3

Hypertension in Pregnancy Management

Answer 3

Usually non pharmacological unless there are significant risk factors
-Close supervision, limitation of activities, bed rest in left lateral position
-Monitor for warning signs of pre-eclampsia, aspirin (see pre-eclampsia)
-If pre-existing, switch away from ARBS/ACEi
Gestational
-Dip urine for protein on every visit
-If mild (140-149/90-99) measure weekly
-If moderate (150-159/100-109) monitor BP twice a week, start labetalol, arrange FBCs, U/Es, LFTs
-If severe (≥160/110), admit and treat as moderate, measure BP 4 times daily, weekly bloods and twice weekly BP and urine dip after discharge
-Continue to monitor after birth