Other management issues

1. Frequent prenatal visits for monitoring maternal blood pressure, proteinuria, and fundal growth and by periodic sonographic estimation of fetal size are recommended.

2. Fetal evaluation. A baseline ultrasound examination is recommended at 16 to 20 weeks of gestation to confirm gestational age. A nonstress test or biophysical profile should be performed weekly starting at 32 weeks.

3. Delivery. Woman with mild, uncomplicated chronic hypertension can be allowed to go into spontaneous labor and deliver at term. Earlier delivery can be considered for women with severe hypertension, superimposed preeclampsia, or pregnancy complications (eg, fetal growth restriction, previous stillbirth).

F. Treatment of hypertension. Antihypertensive treatment is indicated if the systolic blood pressure is >170 mm Hg. The preferred agents are methyldopa for prolonged antenatal therapy, and hydralazine, labetalol or nifedipine for peripartum treatment of acute hypertensive episodes. Sodium restriction and diuretics have no role in therapy. Restricted physical activity can lower blood pressure.

References: See page 184.

Blood Pressure Health

Blood Pressure Health

Your heart pumps blood throughout your body using a network of tubing called arteries and capillaries which return the blood back to your heart via your veins. Blood pressure is the force of the blood pushing against the walls of your arteries as your heart beats.Learn more...

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