1.4.2 In women with gestational hypertension, take account of the following risk factors that require additional assessment and follow-up: nulliparity age 40 years or older pregnancy interval of more than 10 years family history of pre-eclampsia multi-fetal pregnancy BMI of 35 kg/m2 or more gestational age at presentation previous history of pre-eclampsia or gestational hypertension pre-existing vascular disease pre-existing kidney disease. [2010] 1.4.3 Offer women with gestational hypertension the tests and treatment listed Table 1 Management of pregnancy with gestational hypertension Degree of hypertension Hypertension: blood pressure of 140/90 159/ Severe hypertension: blood pressure of 160/ 110 mmHg or more Admission to hospital Do not routinely admit to hospital Admit, but if BP falls below 160/ 110 mmHg then manage as for hypertension Antihypertensive pharmacological treatment Offer pharmacological treatment if BP remains above 140/ Offer pharmacological treatment to all women Target blood pressure once on antihypertensive treatment Aim for BP of 135/85 mmHg or less Aim for BP of 135/85 mmHg or less Blood pressure measurement Once or twice a week (depending on BP) until BP is 135/85 mmHg or less Every 15 30 minutes until BP is less than 160/110 mmHg Dipstick proteinuria testinga Once or twice a week (with BP measurement) Daily while admitted Blood tests Measure full blood count, liver function and renal function at presentation and then weekly Measure full blood count, liver function and renal function at presentation and then weekly PlGF-based testing Carry out PlGF-based testing on 1 occasion (in accordance with NICE guidance, see recommendation 1.4.4) if there is suspicion of pre-eclampsia Carry out PlGF-based testing on 1 occasion (in accordance with NICE guidance, see recommendation 1.4.4) if there is suspicion of pre-eclampsia Fetal assessment Offer fetal heart auscultation at every antenatal appointment Carry out ultrasound assessment of the fetus at diagnosis and, if normal, repeat every 2 to 4 weeks, if clinically indicated Carry out a CTG only if clinically indicated (See section 1.6 for advice on fetal monitoring) Offer fetal heart auscultation at every antenatal appointment Carry out ultrasound assessment of the fetus at diagnosis and, if normal, repeat every 2 weeks, if severe hypertension persists Carry out a CTG at diagnosis and then only if clinically indicated (See section 1.6 for advice on fetal monitoring) a Use an automated reagent-strip reading device for dipstick screening for proteinuria in a secondary care setting. 