ACOG guidance on hypertension in pregnancy

ACOG distinguishes hypertension that was present before pregnancy from hypertension first detected during pregnancy. Preeclampsia is a pregnancy-related disorder in which high blood pressure occurs with signs that organs or the placenta may be affected; it can also begin after birth.

A single raised reading may be repeated because blood pressure varies. Clinicians interpret the pattern alongside the stage of pregnancy, previous readings, symptoms, medicines, and medical history. Urine protein, blood tests for kidney and liver function, platelet levels, and checks of fetal growth or wellbeing may help distinguish chronic hypertension, gestational hypertension, and preeclampsia.

Normal wellbeing does not exclude a blood pressure problem. Monitoring is intended to detect change early and guide decisions about medication, observation, and the timing of birth.

Attend every planned antenatal appointment and use a home monitor only as your maternity team instructs. Record readings with the date, time, symptoms, and any missed medicine, then report results using the thresholds your team has set for you.

Do not start, stop, or change blood pressure medicine or aspirin without the prescriber. Some medicines used outside pregnancy are unsuitable during pregnancy, while stopping treatment abruptly can also be harmful. Continue fetal movement awareness and contact the maternity unit if movements are reduced or different from the baby's established pattern.

Contact your maternity unit immediately for a severe or persistent headache, visual changes, pain high in the abdomen or at the shoulder, sudden swelling of the face or hands, vomiting later in pregnancy, breathing difficulty, vaginal bleeding, or reduced fetal movement. These symptoms need assessment during pregnancy and after delivery.

Call emergency services for a seizure, collapse, severe breathing difficulty, confusion, or stroke-like symptoms such as facial droop, arm weakness, or speech difficulty. Do not drive yourself during a medical emergency.

Ask which type of hypertension they suspect, what home readings should trigger a call, whether your cuff has been checked for fit, which blood and urine tests you need, and how the baby's growth will be monitored. Confirm the exact medicine plan and whom to contact outside clinic hours or after birth.