gynecology and obstetrics
Hypertension in Pregnancy
Key Points
Both chronic and gestational hypertension increase risk of preeclampsia, eclampsia, other causes of maternal mortality or morbidity (eg, hypertensive encephalopathy, stroke, renal failure, left ventricular failure, HELLP syndrome), and uteroplacental insufficiency. Check for other causes of hypertension if severe hypertension occurs for the first time in a pregnant woman who does not have a multifetal pregnancy or gestational trophoblastic disease. If pharmacologic therapy is necessary, start withmethyldopa, a beta-blocker, or a calcium channel blocker. Do not use ACE inhibitors, ARBs, or aldosterone antagonists. Consider hospitalization or termination of pregnancy if BP is > 180/110 mm Hg. 