Hypertension in pregnancy: NICE issues updated quality standard

  • NICE

  • curated by Pavankumar Kamat
  • UK Medical News
Access to the full content of this site is available only to registered healthcare professionals. Access to the full content of this site is available only to registered healthcare professionals.

The National Institute for Health and Care Excellence (NICE) has issued an updated quality standard focusing on diagnosis and management of hypertension and pre-eclampsia during pregnancy, labour and birth. Additionally, it provides advice for women with hypertension planning to conceive and postnatal care for women with a history of hypertension or pre-eclampsia. The updated quality standards aim to align with the recent NICE guidelines on hypertension in pregnancy.

The key goals of the quality standard are improvements in the following areas:

  • Reducing premature mortality;
  • Reducing mortality in babies and young children;
  • Experience of maternity services for women and their families;
  • Reducing the incidence of avoidable harm; and
  • Safety of maternity services.

The quality standard covers the following six recommendations:

  • Women of childbearing potential with treated hypertension should be provided necessary information every year regarding safe antihypertensive therapy during pregnancy.
  • Pregnant women with a high risk for pre-eclampsia when the appointment was made should be offered 75-150 mg of aspirin to be taken daily from 12 weeks until birth.
  • Pregnant women receiving antihypertensive drugs should have a blood pressure target of ≤135/85 mmHg.
  • Pregnant women with severe hypertension should be admitted for a complete evaluation, performed by a healthcare professional with expertise in managing hypertension in pregnancy.
  • Hospital admission and monitoring are recommended for pregnant women with pre-eclampsia having severe hypertension, an increased risk for adverse events or any other clinical concerns.
  • A senior obstetrician should be involved in the decision-making process regarding the timing of birth for women with pre-eclampsia.
  • Women who have experienced hypertension in pregnancy should receive a plan for ongoing antihypertensive management as a part of their postnatal care planning. The plan should be communicated to their general practitioner at the time of transfer to community care after birth.
  • Women with a history of gestational hypertension or pre-eclampsia should discuss future pregnancy and lifetime cardiovascular risks at the time of their six- to eight-week postnatal medical review.