Hypertensive Disorders of Pregnancy: Part II Management and Treatment

Course overview

Hypertensive disorders of pregnancy complicate up to 22% of all pregnancies and account for approximately 16% of maternal deaths in the U.S. Hypertensive disorders of pregnancy generally occur in the second half of pregnancy, increasing in frequency as term approaches. They manifest in postpartum as well. Along with hemorrhage, infection and cardiovascular disorders, they represent a major cause of maternal mortality and can pose significant fetal risk. To help improve maternal and fetal outcomes, national safety initiatives have been initiated with focus on standardization and rapid intervention for critical values. It is crucial for practitioners to diagnose hypertensive disorders early and follow these patients carefully throughout the postpartum period, and in some cases as far out as one year post-delivery due to alteration of maternal physiology. In this activity we cover management and treatment for hypertensive disorders of pregnancy. We will also review management and treatment of severe manifestations such as preeclampsia, HELLP syndrome, severe hypertension, eclamptic seizures, and potential post-delivery complications. After completing this activity, practitioners should be able to: identify critical threshold blood pressure values that require immediate intervention; recognize the importance of standardized order sets for emergency use during hypertensive crisis; discuss low-dose aspirin as a therapy for prevention of preeclampsia; and examine management and treatment options for maternal hypertensive disorders.