Management of Hypertensive Crisis for the Obstetrician/Gynecologist

Obstet Gynecol Clin North Am. 2016 Dec;43(4):623-637. doi: 10.1016/j.ogc.2016.07.005. Epub 2016 Oct 14.

Abstract

Hypertensive disorders of pregnancy are among the leading preventable contributors of maternal and fetal adverse outcomes, including maternal and fetal death. Blood pressure increase has a strong association with unfavorable pregnancy outcomes, including stroke and pulmonary edema. A persistent blood pressure measurement greater than or equal to 160/110 mm Hg lasting for more than 15 minutes, during pregnancy or postpartum, is considered an obstetric emergency and requires rapid appropriate treatment. Following evidence-based guidelines, implementing institutional polices, and understanding the classification and pathophysiology of hypertensive disorders of pregnancy are essential and can significantly improve the rate of preventable complications.

Keywords: Eclampsia; HELLP syndrome; Hypertension; Hypertensive crisis; Hypertensive urgency/emergency; Preeclampsia; Pregnancy; Pregnancy safety bundles.

Publication types

  • Review

MeSH terms

  • Blood Pressure Determination
  • Disease Management*
  • Early Diagnosis
  • Early Medical Intervention / methods
  • Female
  • Humans
  • Hypertension, Pregnancy-Induced* / classification
  • Hypertension, Pregnancy-Induced* / diagnosis
  • Hypertension, Pregnancy-Induced* / physiopathology
  • Hypertension, Pregnancy-Induced* / therapy
  • Pregnancy
  • Pregnancy Outcome
  • Pulmonary Edema / etiology
  • Pulmonary Edema / prevention & control*
  • Stroke / etiology
  • Stroke / prevention & control*