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A summary of management of gestational hypertension guidance (1) is presented below:
Management of pregnancy with gestational hypertension
Classification of Hypertension | Hypertension: blood pressure of 140/90- 159/ 109mmHg | Severe hypertension: blood pressure of 160/110mmHg or more |
Admission to hospital | Do not routinely admit to hospital | Admit, but if BP falls below 160/ 110 mmHg then manage as for hypertension |
Antihypertensive pharmacological treatment | Offer pharmacological treatment if BP remains above 140/90 mmHg | Offer pharmacological treatment to all women |
Target blood pressure once on antihypertensive treatment | Aim for BP of 135/85 mmHg or less | Aim for BP of 135/85 mmHg or less |
Blood Pressure Measurement | Once or twice a week (depending on BP) until BP is 135/85 mmHg or less | Every 15-30 minutes until BP is less than 160/110 mmHg |
Dipstick proteinuria testing (a) | Once or twice a week (with BP measurement) | Daily while admitted |
Blood Tests | Measure full blood count, liver function and renal function at presentation and then weekly | Measure full blood count, liver function and renal function at presentation and then weekly |
PlGF-based testing | Carry out PlGF-based testing on 1 occasion if there is suspicion of preeclampsia | Carry out PlGF-based testing on 1 occasion if there is suspicion of preeclampsia |
Fetal assessment | Offer fetal heart auscultation at every antenatal appointment Carry out ultrasound assessment of the fetus at diagnosis and, if normal, repeat every 2 to 4 weeks, if clinically indicated Carry out a CTG only if clinically indicated | Offer fetal heart auscultation at every antenatal appointment Carry out ultrasound assessment of the fetus at diagnosis and, if normal, repeat every 2 weeks, if severe hypertension persists Carry out a CTG at diagnosis and then only if clinically indicated |
(a) Use an automated reagent-strip reading device for dipstick screening for proteinuria in a secondary care setting.
Abbreviations: BP, blood pressure; CTG, cardiotography
Notes:
Reference:
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