Hypertension in pregnancy: diagnosis and management

National Institute for Health and Care Excellence

Key priorities for implementation

Reducing the risk of hypertensive disorders in pregnancy

  • Advise women at high risk of pre-eclampsia to take 75 mg of aspirin* daily from 12 weeks until the birth of the baby. Women at high risk are those with any of the following:
    • hypertensive disease during a previous pregnancy
    • chronic kidney disease
    • autoimmune disease such as systemic lupus erythematosis or antiphospholipid syndrome
    • type 1 or type 2 diabetes
    • chronic hypertension

Management of pregnancy with chronic hypertension

  • Tell women who take angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs):
    • that there is an increased risk of congenital abnormalities if these drugs are taken during pregnancy
    • to discuss other antihypertensive treatment with the healthcare professional responsible for managing their hypertension, if they are planning pregnancy
  • In pregnant women with uncomplicated chronic hypertension aim to keep blood pressure lower than 150/100 mmHg

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