Condition management

It is important to complete an individual risk assessment for your patient and to apply the principles of prescribing during pregnancy when looking at the available information and making treatment decisions. Check to see if a risk assessment has already been completed by the specialist team.

Untreated or inadequately treated hypertension can have adverse effects on the mother and therefore on the foetus.

Guidelines

NICE Guideline [NG133] and CKS provide good guidance and information on the management of hypertension in pregnancy. This includes information on:

• pre-eclampsia
• pre-existing hypertension, or hypertension before 20 weeks
• new hypertension after 20 weeks
• proteinuria and no hypertension after 20 weeks
• postpartum follow-up

NICE Clinical guideline [NG133] has a useful interactive flowchart for the diagnosis and management of hypertension in pregnancy including treatment options for chronic and gestational hypertension and pre-eclampsia.

You should check if there is local guidance for you to use in your area.

Pregnancy outcome information

UK Teratology Information Service (UKTIS) provides more detailed information on pregnancy outcomes for the common antihypertensive medicines. They also have overviews on the use of beta-blockers, calcium channel blockers and angiotensin converting enzyme (ACE) inhibitors in pregnancy.

Patient information

Each of the UKTIS summaries has corresponding Best Use of Medicine in Pregnancy (BUMPS) patient information.

The Royal College of Obstetricians and Gynaecologists (RCOG) provides patient information on pre-eclampsia

The NHS website provides an overview of high blood pressure (hypertension) and pregnancy (including pre-eclampsia) and a summary statement on the use in pregnancy of specific antihypertensive medicines.