What are the goals of pharmacologic treatment of hypertensive disorders during pregnancy?

Updated: Jun 12, 2018
  • Author: Michael P Carson, MD; Chief Editor: Edward H Springel, MD, FACOG  more...
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Answer

Answer

In normal pregnancy, women's mean arterial pressure drops 10-15 mm Hg over the first half of pregnancy. Most women with mild chronic hypertension (ie, SBP 140-160 mm Hg, DBP 90-100 mm Hg) have a similar decrease in blood pressures and may not require any medication during this period. Conversely, DBP greater than 110 mm Hg has been associated with an increased risk of placental abruption and intrauterine growth restriction, and SBP greater than 160 mm Hg increases the risk of maternal intracerebral hemorrhage. Therefore, pregnant patients should be started on antihypertensive therapy if the SBP is greater than 160 mm Hg or the DBP is greater than 100-105 mmHg.

The goal of pharmacologic treatment should be a DBP of less than 100-105 mm Hg and an SBP less than 160 mm Hg. Women with preexisting end- organ damage from chronic hypertension should have a lower threshold for starting antihypertensive medication (ie, >139/89) and a lower target blood pressure (< 140/90). [3]


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