The treatment of hypertension in pregnancy

The precise trigger for pre-eclampsia has yet to be elucidated but the pathophysiology involves abnormal placentation and an exaggerated inflammatory response causing a multisystem disorder. Raised or rising blood pressure in a pregnant woman should alert the clinician to look for the development of pre-eclampsia. Diagnosis and treatment of hypertensive disorders in pregnancy is vital they are associated with both a worse maternal and fetal outcome. Current recommendations suggest that all pregnant women with a systolic blood pressure greater than 160 mmHg should have immediate antihypertensive therapy and treatment should be initiated at lower pressures if the overall clinical picture suggests rapid deterioration. Regional anaesthesia is recommended for both labour analgesia and operative delivery. In the presence of compromised placental function and intrauterine growth restriction, regional blockade has the beneficial effect of improving placental blood flow.