Diagnosis and Management of Hypertensive Emergencies Complicating Pregnancy

Acute-onset, severe systolic or diastolic hypertension can occur during pregnancy or in the postpartum period. The American College of Obstetricians and Gynecologists Taskforce on Hypertension during pregnancy recently modified the diagnosis and management of hypertension, describing a hypertensive emergency in pregnancy as persistent (≥ 15 min), acute-onset, severe hypertension, defined as a systolic blood pressure ≥ 160 mmHg or diastolic blood pressure ≥ 110 mmHg. Pregnancy can be complicated by a hypertensive emergency with a lower blood pressure threshold for end-organ damage than non-pregnant patients. Labetalol, hydralazine and nifedipine are all considered first-line anti-hypertensive agents for the treatment of severe hypertension. The objective of this article is to review the current understanding, diagnosis and management of a hypertensive emergency during pregnancy or postpartum.