Blood Pressure Management in Pregnancy

Diagnostic Criteria

The European Society of Cardiology defines hypertension in pregnancy as systolic BP ≥140 mmHg and/or diastolic BP ≥90 mmHg, confirmed on at least 2 separate occasions or at least 15 minutes apart in severe cases 3
A blood pressure of 110/80 mmHg falls well within the normal range and requires no treatment, regardless of the baseline value 1, 2

The European Society of Cardiology recommends initiating drug treatment at BP ≥140/90 mmHg in women with gestational hypertension, pre-existing hypertension with superimposed gestational hypertension, or hypertension with subclinical organ damage 1, 2, 4
For uncomplicated chronic hypertension, treatment should be initiated at BP ≥150/95 mmHg in all other pregnant women without the above features 1, 2, 7
Severe hypertension (BP ≥160/110 mmHg) requires immediate hospitalization and treatment within 15 minutes to prevent maternal stroke 1, 3, 5

No antihypertensive treatment is indicated for a patient whose BP rises from 90/60 to 110/80, as values remain normal 1, 2
The European Society of Cardiology recommends continuing routine prenatal monitoring with BP checks at each visit and monitoring for progression to true hypertension (≥140/90 mmHg) 5
Screening for proteinuria is recommended if BP reaches ≥140/90 mmHg, as approximately 25% of gestational hypertension cases progress to preeclampsia 4, 5