ACOG has released recommendations on chronic hypertension in pregnancy. Management of chronic hypertension in pregnancy depends on gestational age and symptoms. Initial assessment, including identification of end-organ damage and evaluation of medications will drive treatment and delivery planning.
The benefits of treating mild to moderate chronic hypertension in pregnancy are not clear, thus a conversation with patients (i.e. shared decision-making) is warranted. Timing of delivery depends on severity of disease and gestational age. Women with chronic hypertension remain at risk for complications during the postpartum period so early follow-up is recommended.
Choice of Antihypertensive
Initiation of therapy
Patient on medications prior to pregnancy
…expectant management beyond 39 0/7 weeks of gestation should only be done after careful consideration of the risks and benefits and with appropriate surveillance
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