EDUCATION IN HEART

Hypertension

Management of hypertension before, during, and after pregnancy

P Rachael James¹, Catherine Nelson-Piercy²

¹ Department of Cardiology, Royal Sussex County Hospital, Brighton, West Sussex, UK
² Department of Obstetrics, Guys and St Thomas’ Hospitals, London, UK

Correspondence to:
Correspondence to:
Dr Catherine Nelson-Piercy
Department of Obstetrics, Guys and St Thomas’ Hospitals, North Wing, St Thomas’ Hospital, Lambeth Palace Road, London SE1 7EH, UK; catherine.nelson-piercy@gstt.sthames.nhs.uk

Keywords: eclampsia; hypertension; pre-eclampsia; pregnancy

The first 150 words of the full text of this article appear below.

Hypertension is the most common medical problem encountered in pregnancy and remains an important cause of maternal, and fetal, morbidity and mortality. It complicates up to 15% of pregnancies and accounts for approximately a quarter of all antenatal admissions. The hypertensive disorders of pregnancy cover a spectrum of conditions, of which pre-eclampsia poses the greatest potential risk and remains one of the most common causes of maternal death in the UK.

NORMAL PHYSIOLOGICAL CHANGE IN BLOOD PRESSURE DURING PREGNANCY

Early in the first trimester there is a fall in blood pressure caused by active vasodilatation, achieved through the action of local mediators such as prostacyclin and nitric oxide. This reduction in blood pressure primarily affects the diastolic pressure and a drop of 10 mm Hg is usual by 13–20 weeks gestation.¹ Blood pressure continues to fall until 22–24 weeks when a nadir is reached. After this, there is a gradual increase in blood pressure until term when . . . [Full text of this article]

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