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

• The woman should not be discharged home until she has no symptoms of pre-eclampsia, her blood pressure is 149/99 mmHg or lower, and her blood tests are improving.
• All women should be given a care plan that includes information about:
• 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.
• Women with pre-eclampsia who did not take antihypertensive treatment and have given birth and who have been discharged home will have:
• Their blood pressure measured:
• At least once between day 3 and day 5 after birth.
• On alternate days until their blood pressure normalizes, if their blood pressure was abnormal between day 3 and day 5.
• If blood tests are stable or improving but not in the normal range they will be repeated as clinically indicated.
• The aim is to keep blood pressure lower than 140/90 mmHg.
• Antihypertensive treatment will be started if blood pressure is 150/100 mmHg or higher.
• Symptoms of pre-eclampsia, such as severe headache and epigastric pain, will be asked about each time blood pressure is measured.
• Women with pre-eclampsia who took antihypertensive treatment and have given birth will have:
• Their blood pressure measured every 1–2 days for up to 2 weeks after transfer to primary care until the woman is off treatment and has no hypertension.
• If blood tests are stable or improving but not in the normal range, they will be repeated as clinically indicated.
• The antihypertensive treatment used during the pregnancy will be continued, unless the woman has been taking methyldopa, which should be stopped 2 days postpartum because of the risk of depression. Antihypertensive treatment that the woman took before planning a pregnancy will be restarted unless there are contraindications to a particular drug because the woman is breastfeeding or is planning further pregnancies.
• A reduction in antihypertensive treatment will be considered if their blood pressure falls below 140/90 mmHg.
• Antihypertensive treatment will be reduced if their blood pressure falls below 130/80 mmHg.
• Symptoms of pre-eclampsia, such as severe headache and epigastric pain, will be asked about each time blood pressure is measured.
• Women with pre-eclampsia will be offered a medical review either in the community or at the hospital:
• If they remain on antihypertensive treatment 2 weeks after transfer to community care.
• At their 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.
• Perform dipstick testing of the urine. Women with 1+ proteinuria or more but normal blood pressure should be reviewed 3 months postpartum to assess kidney function and to consider referral to a renal specialist.