Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible. Contents Overview 5 Who is it for? 5 1.1 Reducing the risk of hypertensive disorders in pregnancy 6 1.2 Assessment of proteinuria in hypertensive disorders of pregnancy 8 1.3 Management of chronic hypertension in pregnancy 10 1.4 Management of gestational hypertension 14 1.5 Management of pre-eclampsia 18 1.7 Intrapartum care 28 1.8 Medical management of severe hypertension, severe pre-eclampsia or eclampsia in a critical care setting 30 1.9 Antihypertensive treatment during the postnatal period, including during breastfeeding 33 1.10 Advice and follow-up at transfer to community care 35 Terms used in this guideline 39 Recommendations for research 42 Key recommendations for research 42 Other recommendations for research (from 2010 guideline) 43 Rationale and impact 44 Assessment of proteinuria 44 Treatment of chronic hypertension 46 Monitoring and treatment of gestational hypertension 48 Assessment of women with pre-eclampsia 49 Monitoring and treatment of pre-eclampsia and timing of birth 50 Antihypertensive treatment during the postnatal period, including during breastfeeding 52 Risk of recurrence of hypertensive disorders of pregnancy and long-term cardiovascular disease 53 Finding more information and committee details 56 Update information 57 This guideline replaces CG107. This guideline is the basis of QS35. Overview This guideline covers diagnosing and managing hypertension (high blood pressure), including pre-eclampsia, during pregnancy, labour and birth. It also includes advice for women with hypertension who wish to conceive and women who have had a pregnancy complicated by hypertension. It aims to improve care during pregnancy, labour and birth for women and their babies. We've created a series of visual summaries to explain assessment, treatment and other aspects of care for various conditions relating to hypertension in pregnancy. 