Guidelines for the management of hypertensive disorders of pregnancy 2008

Abstract

This is the Executive Summary of updated guidelines developed by the Society of Obstetric Medicine of Australia and New Zealand for the management of hypertensive diseases of pregnancy. They address a number of challenging areas including the definition of severe hypertension, the use of automated blood pressure monitors, the definition of non‐proteinuric pre‐eclampsia and measuring proteinuria. Controversial management issues are addressed such as the treatment of severe hypertension and other significant manifestations of pre‐eclampsia, the role of expectant management in pre‐eclampsia remote from term, thromboprophylaxis, appropriate fluid therapy, the role of prophylactic magnesium sulfate and anaesthetic issues for women with pre‐eclampsia. The guidelines stress the need for experienced team management for women with pre‐eclampsia and mandatory hospital protocols for treatment of hypertension and eclampsia. New areas addressed in the guidelines include recommended protocols for maternal and fetal investigation of women with hypertension, preconception management for women at risk of pre‐eclampsia, auditing outcomes in women with hypertensive diseases of pregnancy and long‐term screening for women with previous pre‐eclampsia.