Hypertensive Emergency in Pregnancy with Severe Hypertension (Systolic BP >160 mmHg)
This protocol addresses the acute management of hypertensive emergency occurring in pregnancy, specifically when systolic blood pressure exceeds 160 mmHg and diastolic blood pressure exceeds 110 mmHg, in the absence of pre-eclampsia.
Clinical scenario
Pregnancy with severe hypertension — systolic BP >160 mmHg and diastolic BP >110 mmHg — without pre-eclampsia. This level of BP elevation is associated with adverse maternal and peri-natal outcomes, independent of pre-eclampsia and potentially of the same magnitude as eclampsia itself, and may necessitate acute BP-lowering therapy.
Treatment approach
Acute management involves drug treatment targeting rapid blood pressure reduction. The protocol specifies which agents are recommended in this setting — and in what context each applies.
Full agent selection, sequencing, and clinical decision criteria are in the structured protocol below.
References
Severe hypertension in pregnancy (without pre-eclampsia) may necessitate acute BP-lowering therapies.
Severe hypertension in pregnancy is defined in general as systolic BP of >160 mmHg and diastolic BP of >110 mmHg and is associated with adverse maternal and peri-natal outcomes independent of pre-eclampsia and potentially of the same magnitude as eclampsia itself.
Drug treatment with i.v. labetalol, oral methyldopa, or oral nifedipine is recommended.
DOI: 10.1093/eurheartj/ehae178
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