Abbreviations: BP, blood pressure; CTG, cardiotocography. 1.5.6 Offer labetalol to treat hypertension in pregnant women with pre- eclampsia. Offer nifedipine[3] for women in whom labetalol is not suitable, and methyldopa if labetalol or nifedipine[3] are not suitable. Base the choice on any pre-existing treatment, side-effect profiles, risks (including fetal effects) and the woman's preference. [2010, amended 2019] Timing of birth 1.5.7 Record maternal and fetal thresholds for planned early birth before 37 weeks in women with pre-eclampsia. Thresholds for considering planned early birth could include (but are not limited to) any of the following known features of severe pre-eclampsia: inability to control maternal blood pressure despite using 3 or more classes of antihypertensives in appropriate doses maternal pulse oximetry less than 90% progressive deterioration in liver function, renal function, haemolysis, or platelet count ongoing neurological features, such as severe intractable headache, repeated visual scotomata, or eclampsia placental abruption reversed end-diastolic flow in the umbilical artery doppler velocimetry, a non- reassuring cardiotocograph, or stillbirth. Other features not listed above may also be considered in the decision to plan early birth. [2019] Be aware that some pulse oximeters can underestimate or overestimate oxygen saturation levels, especially if the saturation level is borderline. Overestimation has been reported in people with dark skin. See also the NHS England Patient Safety Alert on the risk of harm from inappropriate placement of pulse oximeter probes. 1.5.8 Involve a senior obstetrician in any decisions on timing of birth for women with pre-eclampsia. [2010, amended 2019] 1.5.9 Discuss with the anaesthetic team if birth is planned in a woman with 1.5.10 Discuss with the neonatal team if birth is planned in a woman with pre- eclampsia, and neonatal complications are anticipated. 