Pregnant women with combined hypertension are classified into the following five conditions: (1) Gestational hypertension: elevated blood pressure after 20 weeks of gestation, with blood pressure ≥ 140/90 mmHg, without proteinuria and other comorbidities of the pregnant woman, mostly returning to normal blood pressure at 12 weeks postpartum. It accounts for 5-6% of the total number of pregnancies, and the risk of this condition is relatively low. (2) Pre-eclampsia: the traditional definition is the presence of elevated blood pressure after 20 weeks of gestation, with blood pressure ≥ 140/90 mmHg with proteinuria ≥ 300 mg/24 hours, while the new definition also includes other maternal organ insufficiencies, such as renal insufficiency, liver damage, neurological and hematologic involvement, mainly blood and thrombocytopenia, placental dysfunction and intrauterine fetal growth (3) Eclampsia (3) Eclampsia: the combination of pre-eclampsia and the presence of convulsions cannot be explained by other causes. Pre-eclampsia and eclampsia account for 1% of all pregnancies and in both cases, the maternal and fetal risk is extremely high. (4) A previous history of chronic hypertension without significant worsening of blood pressure during pregnancy or manifestations of preeclampsia such as proteinuria. This represents 1% of the total number of pregnancies. In this case, the risk is also relatively low as long as the blood pressure is well controlled. (5) Chronic hypertension complicated by preeclampsia, which is characterized by a sudden increase in blood pressure after 20 weeks of gestation, with manifestations of preeclampsia such as proteinuria, is a high risk. We have seen all five of these conditions. In fact, pregnant women with gestational hypertension and a history of chronic hypertension can generally get through the entire pregnancy week relatively safely as long as there is no proteinuria and no manifestations of other organ involvement and as long as the blood pressure is well controlled. However, in case of complications such as proteinuria and liver and kidney insufficiency, thrombocytopenia and hemorrhage, or even convulsions, pregnant women and fetuses are at serious risk and can be considered as the main cause of maternal and fetal death throughout pregnancy. Unfortunately, there is no clear way to predict which pregnant women with combined elevated blood pressure will develop pre-eclampsia or eclampsia, and while simple prophylactic measures such as low-dose aspirin, calcium antagonists and lifestyle interventions may have a potential role, the overall benefit to the pregnant woman and fetus remains small. Therefore, pre-eclampsia and eclampsia are still an unsolved mystery to us. This is why I often advise patients with hypertension not to risk having a second child. Because no one can predict how your future will end. I often have patients with blood pressure as high as 170-180/110, obese, who have never thought about losing weight properly, and who still want to have a second child. I tell her, you’d better think it over, because as the months of pregnancy increase, your blood pressure may be even higher, and then there will be a sharp rise in blood pressure, marked proteinuria, hypoproteinemia, general edema, including pleural and abdominal effusion, and in severe cases, abnormal liver function, platelet Can you bear such results? In addition, when the mother’s health condition does not allow the pregnancy to continue, the placenta is not functioning well, the placenta is aging or the baby is not developing well in the uterus, and the pregnancy has to be terminated, can you afford the daily tens of thousands of drugs to promote fetal lung maturation? There are also worse cases where both the mother and the baby cannot be saved. So if you are not prepared and financially capable, you should stop while you are ahead and take responsibility for yourself and your first child. For your first child, the most important thing is to have a healthy mother with you, not just a brother or sister. Of course, there are some exceptions to the lucky situation, I have spoken in the microblogging Nanjing Jiangxinzhou demolition of a demolition of a household, because the demolition of a lot of houses and money, rich, of course, have money and leisure, want a second child, but her long-term elevated blood pressure, but no formal hospital examination, long-term use of antihypertensive drugs, blood pressure control is not ideal, but she still very much want a second child, I was at first also painstakingly with At first, I told her to think it over. Finally, I couldn’t resist her, so I said, “How about this? Let’s first do some routine tests to see if your long-term high blood pressure has caused damage to your heart, kidneys and other organs. The results showed that the blood potassium was obviously low, and since the patient had no obvious family history of hypertension, she was advised to have tests to rule out the possibility of secondary hypertension. The tumor was finally removed by a minimally invasive laparoscopic operation by the urology department, and her blood pressure was normalized. This is a very, very lucky situation, but most people are not so lucky. But for a mother who has her first child, maybe she has high blood pressure, maybe she is advanced in age, maybe she may have gestational hypertension or even pre-eclampsia or eclampsia, no matter what, if you must try, I suggest trying to do the following six things: (1) Try to control your weight, lose weight, improve your lifestyle, such as low salt and low fat diet, quit smoking and drinking, avoid staying up late, do not drink (2) Avoid the use of antihypertensive drugs during the first trimester of pregnancy, SMFM recommends a blood pressure of 140-160 mmHg systolic and/or 90-110 mmHg diastolic. Mild-moderate hypertension between 140-160 mmHg systolic and/or 90-110 mmHg diastolic, and without target organ damage, can be treated without antihypertensive drugs, first by non-pharmacological means, and only with antihypertensive drugs when blood pressure is severely elevated. Therefore, try to avoid conception in the cold winter months because the cold will stimulate the increase of blood pressure. (3) The first-line drugs for combined hypertension in pregnancy are methyldopa and labetalol, and the second-line drug is extended-release nifedipine; however, the pitfall is that only labetalol and extended-release nifedipine are available in China, and methyldopa can only be recommended to patients to buy in Hong Kong. (4) Angiotensin-converting enzyme inhibitors and angiotensin receptor antagonists are prohibited throughout pregnancy, and those with the chemical name followed by “Priligy” and “Sartan” are prohibited because they can lead to fetal nephrotoxicity and renal insufficiency and The kidney causes fetal death. (5) Regular work and rest throughout the pregnancy week, to develop a good lifestyle, to avoid gaining too much weight too fast, and to strengthen the monitoring of blood pressure, as well as regular monitoring of urine routine to see if there is proteinuria, and regular monitoring of blood routine and liver and kidney function, once the problem arises, promptly seek medical advice. (6) There are many ways to treat hypertension in pregnancy, especially pre-eclampsia and eclampsia, but the most important is to terminate the pregnancy at the right time, and in case of crisis, a cesarean section will be performed. From the decision to deliver the fetus by cesarean section to the birth of the fetus, this is all the time given by the operation of two lives, so for the pregnant woman and the fetus, time is life! So with the help of #NationalHypertensionDay, I urge mothers-to-be and those who are already pregnant to pay attention to their blood pressure, have regular maternity checkups, detect problems early and treat them early, and don’t go to the hospital only when the condition has reached an unmanageable point.