Severe hypertension can be a life-threatening event during pregnancy and requires special vigilance in the postpartum period, particularly following hospital discharge. The goal of treatment is to control hypertension and prevent seizures. Uncontrolled hypertension can lead to heart failure, myocardial ischemia, renal injury and stroke.
Urgently treat acute onset severe hypertension in pregnancy or postpartum period
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Note: ACOG states that “any of these agents can be used to treat acute severe hypertension in pregnancy” | An approach detailed in ACOG guidance uses “an initial regimen of labetalol at 200 mg orally every 12 hours and increase the dose up to 800 mg orally every 8–12 hours as needed (maximum total 2,400 mg/d). If the maximum dose is inadequate to achieve the desired blood pressure goal, or the dosage is limited by adverse effect, then short-acting oral nifedipine can be added gradually”
ACOG Practice Bulletin 222: Gestational Hypertension and Preeclampsia
ACOG II Severe Hypertension in Pregnancy Bundle
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