ABSTRACT
Hypertension in pregnancy may be divided into pre-existing hypertension, pregnancy-induced hypertension and pre-eclampsia. Although pre-eclampsia is more common in primiparous women, it is the multiparous women with pre-eclampsia who develop more severe disease and have higher morbidity and mortality rates. Management of women with hypertension in pregnancy can be considered as Mild cases, especially where there is no evidence of pre-eclampsia, may be managed as outpatients. National Institute for Care and Excellence recommends that admission is not mandatory for pre-eclampsia and that individual risk assessment regarding place of care is appropriate. Diuretics to treat hypertension are normally avoided in pregnancy as in pre-eclampsia they cause further depletion of reduced intravascular volume. Their use should be reserved for the treatment of heart failure, pulmonary oedema and idiopathic intracranial hypertension intracranial hypertension’. Any woman on maintenance antihypertensive therapy with an angiotensin-converting enzyme inhibitor should discontinue this prior to pregnancy (and if necessary switch to an alternative suitable for pregnancy such as amlodipine).
