This protocol applies when standard antihypertensive treatment for preeclampsia has been used and blood pressure has not reached the target, with criteria for severe disease now present. It covers the clinical steps taken at this point.
First-line antihypertensive therapy — labetalol, or nifedipine, or methyldopa if the prior agents were unsuitable — was initiated with a target of blood pressure below 135/85 mmHg. Escalation to this protocol is indicated when that blood pressure target has not been achieved.
When thresholds for severe pre-eclampsia are met, management involves planning birth before 37 weeks. For women with preterm disease where early birth is planned, specific intravenous therapy and antenatal agents may be indicated — the full indications and sequencing are available in the complete protocol.