The goal of BP management in pregnancy is to maintain systolic BP between 130 and 155 mmHg and diastolic BP between 80 and 105 mmHg, with lower target ranges in the context of comorbidity; however, the treatment rationale for women with mild to moderate high BP in preg- nancy is not as clear-cut as for severe high BP in pregnancy because maternal and fetal risk-benefit ratios have not been For example, a meta-analysis that examined the association between reduction in maternal BP and fetal growth found that a 10-mmHg decrement in maternal mean arterial pressure was associated with a 176-g decrease in neo- natal birth weight, regardless of the antihypertensive agent In addition, Abalos et al132 performed a meta-analysis of randomized controlled trials of treatment versus no treat- ment of mild to moderate high BP in pregnancy. Although the risk for development of severe hypertension in pregnancy was reduced by 50% in the treatment group (19 trials, 2409 women; RR, 0.50; 95% CI, 0.41 0.61; number needed to treat, 10), there was no statistically significant difference in risk for preeclampsia (22 trials, 3081 women; RR, 0.73; CI 0.50 1.08) and no evidence for benefit or harm to the fetus. Severe hypertension in pregnancy is categorized with the same criteria as for stage 2 hypertension in nonpregnant adults according to the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (BP 160/110 mmHg) and is associated with high risk for stroke and eclampsia.131,161 The American College of Obstetricians and Gynecologists recommends treatment of severe hypertension and suggests labetalol as first-line therapy,121 and it recommends avoidance of atenolol, angiotensin-converting enzyme inhibitors, and angiotensin receptor blockers. 