Care of the patient with severe pregnancy induced hypertension.
Pregnancy induced hypertension remains the largest cause of maternal death in the UK. This is often related to inadequate or incorrect care. Recent randomised studies have enabled evidenced based clinical practice to be directed to the management of this condition. This allows a logical stepwise management structure to be developed in each hospital to make sure all women at risk get the best care available. This starts with comprehensive antenatal care with close collaboration between all professionals involved, early referral to an outpatient daycare unit if hypertension develops or is suspected, early use of antihypertensive therapy to control blood pressure once the diastolic is persistently above 100 mmHg, the use of magnesium sulphate to control convulsions, delivery on the best day in the best way and careful fluid management after delivery. Postnatal care should also contain risk assessment to allow directed counseling to the women concerning subsequent pregnancies.
Walker
J J
JJ
Department of Obstetrics and Gynecology, St James University Hospital, Leeds, UK. msjjjw@gps.leeds.ac.uk
D000927:Anticonvulsants / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000009:adverse effects / Q000627:therapeutic use; D036861:Delivery, Obstetric; D004461:Eclampsia / Q000150:complications / Q000628:therapy; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000401:mortality / Q000628:therapy*; D011225:Pre-Eclampsia / Q000150:complications / Q000628:therapy; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000628:therapy*; D011256:Pregnancy Outcome; D018570:Risk Assessment; D006113:United Kingdom
D000927:Anticonvulsants; D000959:Antihypertensive Agents