Pregnancy-induced hypertension (gestational hypertension)

Pregnancy-induced hypertension (gestational hypertension)

Gestational hypertension, also known as pregnancy-induced hypertension (PIH), is the development of new-onset hypertension after 20 weeks of gestation in the absence of proteinuria or other features of pre-eclampsia.

It usually resolves within 12 weeks postpartum.

Non-pharmacological treatment

• Adequate rest at home and avoidance of strenuous activities

• Eat a normal balanced diet and drink plenty of oral fluids

• Schedule antenatal visits every 2 weeks until 32 weeks of gestation and weekly thereafter

• Recommend delivery in a hospital setting

• Plan delivery at 37 completed weeks of gestation

Pharmacological treatment

A.Mild hypertension

(Systolic blood pressure 140–159 mmHg and/or diastolic blood pressure 90–109 mmHg)

Pharmacological treatment

• Methyldopa (PO) 250–500 mg every 8 hours OR Nifedipine (PO) 20 mg every 12 hours OR Labetalol (PO) 100 mg every 12 hours.

B.Severe hypertension

Severe hypertension is defined as a blood pressure of 160/110 mmHg or higher. The patient should be admitted to hospital for close monitoring and management.

Pharmacological treatment

• Methyldopa (PO) 500 mg every 8 hours AND Hydralazine (slow IV) 10 mg stat administered over 4–5 minutes

  • (Recheck blood pressure after 20 minutes

  • If diastolic blood pressure remains ≥110 mmHg, administer an additional dose of hydralazine (slow IV) 5–10 mg AND Nifedipine (PO) 20 mg every 12 hours OR Labetalol (PO) 100 mg every 12 hours

Note

• Ensure slow administration of hydralazine

• Monitor closely for hypotension when using hydralazine

Referral

• Refer to the next-level facility if there is no improvement.