गंभीर गर्भावस्था उच्च रक्तचाप: जब प्रथम-पंक्ति एंटीहाइपरटेंसिव चिकित्सा से रक्तचाप नियंत्रण न हो तो क्या करें

References

DOI: 10.1016/j.preghy.2021.09.008

1. Hypertension arising de novo at ≥ 20 weeks' gestation in the absence of proteinuria or other findings suggestive of pre-eclampsia.
2. Severe hypertension in pregnancy (i.e., sBP ≥ 160 mmHg or dBP ≥ 110 mmHg) requires urgent antihypertensive therapy, in a monitored setting (⊕⊕OO/Strong).
3. If nifedipine or hydralazine were the initial drug used, choose oral labetalol or oral methyldopa as the alternative.
4. Second-line agents include other beta-blockers, other calcium channel blockers, and prazosin.
5. 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.
6. The target BP for antihypertensive therapy should be a dBP of 85 mmHg, regardless of sBP (⊕⊕⊕⊕/Strong).