How do you manage pregnancy hypertension?

Hypertension in pregnancy is categorized as chronic hypertension, gestational hypertension, and preeclampsia. Chronic hypertension refers to hypertension that is confirmed to exist before pregnancy or occurs in the first 20 weeks of pregnancy. Gestational hypertension is hypertension that occurs after 20 weeks of gestation, is not accompanied by significant proteinuria, and can return to normal at the end of pregnancy. Pre-eclampsia was defined as elevated blood pressure after 20 weeks of gestation with clinical proteinuria (24-hour urine protein greater than 300 mg). Severe preeclampsia was defined as blood pressure ≥160/110 mmHg with massive proteinuria and the presence of headache, blurred vision, pulmonary edema, oliguria, and abnormal laboratory tests (e.g., decreased platelet counts, liver enzyme abnormalities), often combined with abnormal placental function. Non-pharmacologic measures (salt restriction, potassium-rich diet, appropriate activity, emotional relaxation) are safe and effective treatments for hypertension in pregnancy and should be used as the basis for pharmacologic therapy. Drug selection and application are limited by the lack of rigorous clinical validation of the safety of all antihypertensive drugs for the fetus. Antihypertensive drugs should not be too aggressive during pregnancy. Pharmacologic therapy should be initiated when blood pressure is ≥150/100 mmHg after nonpharmacologic measures, with the goal of controlling blood pressure to 140/8090 mmHg. antihypertensive drugs should be used cautiously when necessary. Commonly used intravenous antihypertensive agents include methyldopa, labetalol, and magnesium sulfate; oral agents include B-blockers or calcium channel blockers; magnesium sulfate is the drug of choice for the treatment of preeclampsia. ACEIs or ARBs are contraindicated during pregnancy.