CARE OF THE PATIENT WITH SEVERE PREGNANCY-INDUCED HYPERTENSION

Pregnancy induced hypertension remains the largest cause of maternal d eath in the UK. This is often related to inadequate or incorrect care. Recent randomised studies have enabled evidenced based clinical pract ice to be directed to the management of this condition. This allows a logical stepwise management structure to be developed in each hospital to make sure all women at risk get the best care available. This star ts with comprehensive antenatal care with close collaboration between all professionals involved, early referral to an outpatient daycare un it if hypertension develops or is suspected, early use of antihyperten sive therapy to control blood pressure once the diastolic is persisten tly above 100 mmHg, the use of magnesium sulphate to control convulsio ns, delivery on the best day in the best way and careful fluid managem ent after delivery. Postnatal care should also contain risk assessment to allow directed counseling to the women concerning subsequent pregn ancies.