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NICE publish guideline on hypertension in pregnancy: diagnosis and management

For Hypertension

The National Institute for Health and Care Excellence (NICE) have published a guideline on the diagnosis and management of hypertension in pregnancy.

The guideline covers diagnosing and managing hypertension (high blood pressure), including pre-eclampsia, during pregnancy, labour and birth. It also includes advice for women with hypertension who wish to conceive and women who have had a pregnancy complicated by hypertension. It aims to improve care during pregnancy, labour and birth for women and their babies.

Recommendations
This guideline includes new and updated recommendations on:
  • assessing proteinuria (the presence of abnormal quantities of protein in the urine)
  • managing chronic hypertension in pregnancy and gestational hypertension
  • managing pre-eclampsia, including severe pre-eclampsia in critical care settings (eclampsia is where convulsions occur in a pregnant woman suffering from high blood pressure)
  • treatment during the postnatal period (including breastfeeding)
  • advice and follow-up in community care
It also includes recommendations on:
  • reducing the risk of hypertension in pregnancy
  • fetal monitoring and care of women during labour and birth
Who is it for?
  • Women who develop hypertension during pregnancy, who have hypertension and wish to conceive, and who have had a pregnancy complicated by hypertension, and their relatives and carers
  • Healthcare professionals

The guideline covers:
High blood pressure during pregnancy: the care you should expect
Making decisions together

High blood pressure during pregnancy: the care you should expect
Most women don’t have problems with their blood pressure during pregnancy. A few women do have high blood pressure (hypertension), either because they had it before they were pregnant or they develop it during pregnancy. The right way to manage high blood pressure varies, but if it’s not well controlled it can lead to complications for both the mother and her baby. It can also increase the risk of pre-eclampsia, a sudden rise in blood pressure after 20 weeks of pregnancy that can be dangerous if it’s not treated quickly, so extra care and check-ups are very important.

We want this guideline to make a difference by making sure:
  • pregnant women who develop high blood pressure are offered the right tests and treatments to keep their blood pressure within a safe range for them and their baby
  • women who are taking medicine for blood pressure and want to try for a baby (or have found they are pregnant) are given the best advice about the safety of different medicines for their baby
  • women have good advice and support, including how to spot signs of pre-eclampsia (see the NHS website) and what to do
  • care teams give women the right follow-up care and check-ups after they have given birth.
Making decisions together
Decisions about treatment and care are best when they are made together. Your care team should give you clear information, talk with you about your options and listen carefully to your views and concerns. They should also discuss with you:
  • how it might affect your birth plan if you develop high blood pressure during your pregnancy
  • how best to control your blood pressure after your baby is born, and what happens if you have to take medicine while breastfeeding
  • your likelihood of developing high blood pressure in the future (including in future pregnancies)
If you can’t understand the information you are given, tell your healthcare professional.

© NICE [2019]

Hypertension in pregnancy: diagnosis and management. NICE guideline [NG133]. Published date: June 2019
Available from: See Link below. All rights reserved. Subject to Notice of rights
NICE guidance is prepared for the National Health Service in England. All NICE guidance is subject to regular review and may be updated or withdrawn. NICE accepts no responsibility for the use of its content in this product/publication.

The information provided by NICE was accurate at the time this article was issued.


Link to NICE guidance: Hypertension in pregnancy: diagnosis and management

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