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.

Join

Join to view the rest of this content, as well as access all the benefits of joining NASGP.

Join

Login

Already a member? Login to view this content.

Login

"I feel strongly that sessional GPs need an organisation solely focussed on representing their interests."

Dr Tim Cantor

See the full list of features within our NASGP membership plans

Membership