علاج ارتفاع ضغط الدم الحملي مع ضغط انقباضي حاد ≥160 ملم زئبق أو ضغط انبساطي ≥110 ملم زئبق

References

DOI: 10.1016/j.preghy.2021.09.008

• Hypertension arising de novo at ≥ 20 weeks' gestation in the absence of proteinuria or other findings suggestive of pre-eclampsia.
• Severe hypertension in pregnancy (i.e., sBP ≥ 160 mmHg or dBP ≥ 110 mmHg) requires urgent antihypertensive therapy, in a monitored setting (⊕⊕OO/Strong).
• Severe hypertension should be treated with the first-line agents oral nifedipine, oral labetalol, intravenous (IV) labetalol, or IV hydralazine (⊕⊕⊕O/Strong).
• The most commonly-recommended agents for treatment of severe hypertension are IV labetalol, oral nifedipine, and IV hydralazine.
• When severe hypertension has resolved, switch to routine oral medication.
• The target BP for antihypertensive therapy should be a dBP of 85 mmHg, regardless of sBP (⊕⊕⊕⊕/Strong).
• Nevertheless, success has been achieved without adverse effects when BP has been lowered within one hour.
• If systolic BP (sBP) is ≥160 mmHg, increase dose of existing medication or start new antihypertensive medication to get sBP < 160 mmHg, regardless of diastolic BP.