This protocol applies to individuals with hypertension who are currently pregnant or who are planning a pregnancy — a population that requires both effective blood pressure control and careful attention to fetal safety.
Agent selection in this setting is shaped by the need to minimise fetal risk alongside controlling maternal blood pressure. Reducing the risk of preeclampsia is an additional clinical priority throughout pregnancy.
First-line management centres on chronic antihypertensive maintenance therapy using agents specifically preferred in pregnancy for their established safety profile. Preeclampsia risk reduction is also addressed as part of the structured regimen.
DOI: 10.1161/CIR.0000000000001356
For individuals with hypertension who are planning a pregnancy or who become pregnant, labetalol and extended-release nifedipine are preferred agents to treat hypertension and minimize fetal risk.
Pregnant individuals with chronic hypertension (defined as prepregnancy hypertension or SBP 140 to 159 mm Hg and/or DBP 90 to 109 mm Hg prior to 20 weeks' gestation) should receive antihypertensive therapy to achieve BP <140/90 mm Hg to prevent maternal and perinatal morbidity and mortality.
Individuals with hypertension who are planning a pregnancy or who become pregnant should be counseled about the benefits of low-dose (81 mg/day) aspirin to reduce the risk of preeclampsia and its sequelae.
View source ↗