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Hypertension in pregnancy - Management
How do I manage a woman at high risk of developing pre-eclampsia?

For women at high risk of pre-eclampsia:

  • Give advice about a healthy lifestyle.
    • Advice should be the same as for healthy pregnant women and should include advice regarding rest, work, exercise, and weight. Beginning or continuing a moderate course of exercise during pregnancy is not associated with adverse outcomes.
  • Prescribe aspirin 75 mg daily from 12 weeks of gestation until the birth of the baby:
    • If the woman has either:
      • One or more high risk factors for developing pre-eclampsia.
      • Two or more moderate risk factors for developing pre-eclampsia.
    • Seek specialist advice before prescribing aspirin:
      • For girls younger than 16 years of age.
      • If blood pressure is uncontrolled or if the woman has thrombophilia.
  • Dipstick the urine for protein at initial presentation and each subsequent antenatal visit.
  • Warn about symptoms of pre-eclampsia and advise the woman to seek immediate advice if she develops any of the following (including during the postpartum period):
    • Severe headaches (increasing frequency unrelieved by regular analgesics).
    • Vision problems, such as blurred vision, flashing lights, double vision, or floating spots.
    • Persistent new epigastric pain or pain in the right upper quadrant.
    • Vomiting.
    • Breathlessness.
    • Sudden swelling of the face, hands, or feet.

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