c

e-learning | Hypertension in pregnancy

10th January 2020 by Louise Hudman

e-learning | Hypertension in pregnancy

This is an updated guideline from NICE on managing hypertension in pregnancy. It was first published in 2010 and has been updated in June 19.

I will do a summary of the bits of the guideline that are relevant to us, but the following are some of the key changes:

  • Choice of medications. This has been tightened up. Now they advise labetolol first line, nifedipine second line and methyldopa third line.
  • Target BP level. This has been lowered. For both chronic and gestational hypertension, the target BP is now 135/85.
  • Risk of recurrence. There is a 1 in 5 chance of recurrence in future pregnancies.
  • Future risks. There is a small increased risk of cardiovascular disease in later life in people who have had hypertensive problems in pregnancy.
  • Aspirin should be used from 12/40 until birth at a dose of 75 – 150mg (there is no clear evidence about the best dose). This is unlicensed. This isn’t new advice, but I thought it worth highlighting as often we may need to initiate it. Women need it who have chronic hypertension or have risk factors for pre-eclampsia as advised below.
  • Patients who had pre-eclampsia should have their urine dipped at 6-8/52. If they still have 1+ or more of protein, they need a further review at three months.

Definitions

Chronic hypertension. This is pre-existing hypertension that was present at the time of booking, or where it presents before 20/40.

Read more

No credit card details needed – it takes two minutes.

Join free trial

Login

Already a member? Login to view this content.

Login

"LocumDeck has given me the opportunity to work in different practices and meet new colleagues. I enjoy the flexibility of working on a locum basis. I found the initial setting up process straightforward, and there is plenty of help with the set up guides as well as support from Katrina Munro, the Nurse Ambassador at Frimley Training Hub, and Becky Nelson, the Nurse Support Manager at LocumDeck. I now have regular bookings on days and times which suit me."

Anon nurse, Frimley

See the full list of features within our NASGP membership plans

Membership