Hypertensive Emergency
ICD-10 I16.1 · ICD-11 BA03.1

Treatment of Hypertensive Emergency in Pregnancy with Severe Hypertension (Systolic BP >160 mmHg)

Acute, markedly elevated blood pressure during pregnancy requires prompt clinical attention. This protocol addresses the specific scenario of a pregnant patient meeting the threshold for severe hypertension, in the absence of pre-eclampsia.

Clinical scenario: Pregnancy with severe hypertension — systolic BP >160 mmHg and diastolic BP >110 mmHg — without pre-eclampsia. Severe hypertension at these thresholds is associated with adverse maternal and peri-natal outcomes independent of pre-eclampsia, and acute blood pressure–lowering therapy is indicated.

Treatment approach

Acute management involves intravenous antihypertensive therapy. The complete agent selection, sequencing, and monitoring criteria are in the full protocol …

References
DOI: 10.1093/eurheartj/ehae178

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.

Intravenous hydralazine is a second-line option.

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