How to assess and manage hypertension during and after pregnancy

Louise A McKenna, Shahyza S Huda, Dilys J Freeman, Eleanor Jarvie

Hypertensive disorders of pregnancy are increasingly important complications of which clinicians should have an up-to-date knowledge to facilitate prompt recognition, diagnosis and management. These disorders affect a growing number of pregnancies worldwide, with incidence rates likely to increase in the future commensurate with increasing maternal age and maternal comorbidities independent of age, with consequent effects on maternal and fetal/neonatal morbidity and mortality rates. This article mainly focuses on management within the UK of these disorders, examining their current working definitions, detection methods and recent developments in screening tool development. The current NICE-recommended strategies for treating these disorders and minimizing their occurrence in pregnancy are also explored. In addition, the association between adverse pregnancy outcome and increased risk of future maternal and offspring cardiovascular disease is described, with comments on future strategies to help minimize these potential risks.