The following is a summary of secondary care management recommended by the National Institute for Health and Clinical Excellence (NICE).

• Most women will be followed up by the maternity unit until their blood pressure has returned to normal or until the woman has been referred to a specialist for a medical review should her blood pressure remain elevated. The woman should be given a care plan by the hospital detailing:
• Who will provide follow-up care, including medical review if needed.
• Frequency of blood pressure monitoring.
• Thresholds for reducing or stopping treatment.
• Indications for referral to primary care for blood pressure review.
• Self-monitoring for symptoms of pre-eclampsia.
• The woman should have her blood pressure measured:
• Daily for the first 2 days after birth.
• At least once between day 3 and day 5 after birth.
• As clinically indicated if antihypertensive treatment is changed after birth.
• If the woman has not taken any antihypertensive treatment during pregnancy:
• Aim to keep her blood pressure lower than 140/90 mmHg.
• Antihypertensive treatment will be started if blood pressure rises above 149/99 mmHg.
• If antihypertensive treatment has been used during the antenatal period:
• The same treatment will be continued, unless the woman has been taking methyldopa which should be stopped 2 days postpartum because of the risk of depression.
• If blood pressure falls below 140/90 mmHg, reducing antihypertensive treatment will be considered.
• Antihypertensive treatment will be reduced or stopped if the woman's blood pressure falls below 130/80 mmHg.
• If the woman has gestational hypertension she should be offered a medical review either in the community or at the hospital:
• If she remains on antihypertensive treatment 2 weeks after transfer to community care.
• At her post-natal review 6–8 weeks after the birth.
• Women who still need antihypertensive medication at the time of this review should be offered a specialist assessment of their hypertension.