Hypertension in pregnancy - Treatment of acute severe hypertension

Acute severe hypertension:
BP should be reduced quickly and effectively but gradually.
Over-enthusiastic lowering may result in marked hypotension leading to maternal and fetal hypoxia.
1.Hydralazine: Intermitent boluses of 5mg every 20 to 30 min, maximum of 30mg.
If BP does not fall after 3 doses , continuous infusion of hydralazine as 50 mg in 50 ml of NS with infusion rate of 10ml/hr, the rate may increased by 5 ml/hr after every 15 min unil BP is controlled. Pulse rate should be less than 120/ min.
2.Labetalol: IV labetalol lowers BP smoothly and rapidly without tachycardia.
Around 20 mg IV initially, doubling the dose every 10 min, till a cumulative dose of 300mg is reached.
3.Nifedipine: 5 to 10 mg orally, onset of action in 10 to 15 min. Repeat dose 10 mg every 30 to 60 min.
4.Sodium nitroprusside: Short acting vasodilator of both arterial and venous smooth musle. IV infusion at a rate of 0.25 micro g/ kg/ min.
Increased to a maximum dose of 8 microg/ kg/min.


-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