Hypertension in pregnancy - Management of severe hypertension

Severe hypertension:
Should be hospitalized.
Rest & antihypertensive therapy are necessary to reduce the risk of stroke, CHF or renal failure.
Control of severe HTN may permit prolongation of pregnancy.
If BP is uncontrolled, proteinuria is progressive or signs & symptoms of impending eclampsia develop, intervention becomes essential in  maternal interest.

Antepartum surveillance:
Once the pt is hospitalized,
▪BP recording - twice daily
▪Urine albumin - once daily ▪Biochemical parameters -once or twice a week.
Tests of fetal wellbeing:
▪DFMC (Daily fetal movement count)
 ▪Twice weekly NST (non stress test)
 ▪Biophysical profile-once weekly
▪Fetal growth & liquor volume by USG Doppler studies are useful if fetus is SGA, to determine the frequency of testing & optimum time for delivery.


-Hypertension in pregnancy-classification
-Hypertension in pregnancy-gestational hypertension
-Preeclampsia
-Eclampsia, preeclamsia superimposed on chronic hypertension
-Chronic hypertension
-Hypertension in pregnancy-etiology and pathogenesis
-Pathology
-Mild hypertension in pregnancy-prevention and management
-Severe hypertension in pregnancy-management
-Severe preeclampsia in pregnancy-management
-Complications of hypertension
-Antihypertensive therapy- centrally acting drugs
-Antihypertensive therapy-beta blockers, calcium channel blockers
-Antihypertensive therapy-alpha blockers, vasodilator, diuretics, ACE inhibitors
-Acute severe hypertension - treatment
-Eclampsia - signs and symptoms
-Eclampsia - management