title: Management of severe hypertension in pregnancy.
abstract: While hemorrhage is the leading cause of maternal death in most of the world, hypertensive disorders of pregnancy are the leading cause of maternal mortality in the United States. The opportunity to improve outcomes lies in timely and appropriate response to severe hypertension. The purpose of this article is to review the diagnostic criteria for severe hypertension, choice of antihypertensive agents, and recommended algorithms for evaluation and management of acute changes in clinical status. Adhering to standard practices ensures that care teams can timely and appropriate care to these high risk patients. With heightened surveillance and prompt evaluation of signs and symptoms of worsening hypertension, maternal morbidity and mortality can be decreased.
authors.affiliation: Department of Obstetrics and Gynecology, Columbia University Medical Center, PH 16-66 622 W 168th St, New York, NY 10032. Electronic address: lm3000@cumc.columbia.edu.
authors.forename: Leslie A
authors.initials: LA
authors.lastname: Moroz
authors.affiliation: Department of Obstetrics and Gynecology, Columbia University Medical Center, PH 16-66 622 W 168th St, New York, NY 10032.
authors.forename: Lynn L
authors.initials: LL
authors.lastname: Simpson
authors.affiliation: Division of Maternal-Fetal Medicine, North Shore-LIJ Health System, Manhasset, NY.
authors.forename: Burton
authors.initials: B
authors.lastname: Rochelson
mesh_terms: D000465:Algorithms; D000927:Anticonvulsants / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D000066491:Clinical Decision-Making; D003661:Decision Support Techniques; D005260:Female; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000175:diagnosis* / Q000188:drug therapy* / Q000401:mortality; D008278:Magnesium Sulfate / Q000627:therapeutic use; D008428:Maternal Mortality; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D011295:Prenatal Care / Q000379:methods* / Q000592:standards; D012720:Severity of Illness Index; D014481:United States / Q000453:epidemiology
chemical_list: D000927:Anticonvulsants; D000959:Antihypertensive Agents; D008278:Magnesium Sulfate
keywords: Severe hypertension; antihypertensive therapy; postpartum hypertension; preeclapsia