ABSTRACT
A pregnant woman who experiences severe hypertension is at increased risk of serious morbidity, including abruptio placentae, hypertensive encephalopathy, acute kidney injury, and cerebrovascular accident. There is a significant long-term morbidity from these events, which justifies efforts at prevention. This chapter describes the identification and treatment of acute severe hypertension and persistent severe hypertension related to pregnancy, primarily with the use of algorithms and tables that can be made available at the sites where these women are cared for, the emergency department (ED), the labor and delivery suite, and hospital wards. Some classifications of hypertensive disorders in pregnancy have deemphasized the importance of proteinuria. This is due to the fact that not all patients present with the same signs and symptoms nor with the same laboratory abnormalities, because the disease does not affect all organs to an equal degree.
