[2010, amended 2019] 1.7.4 Continue use of antenatal antihypertensive treatment during labour. Haematological and biochemical monitoring 1.7.5 Determine the need for haematological and biochemical tests during labour in women with hypertension using the same criteria as in the antenatal period even if regional analgesia is being considered. [2010] Care during epidural analgesia 1.7.6 Do not preload women who have severe pre-eclampsia with intravenous fluids before establishing low-dose epidural analgesia or combined spinal epidural analgesia. [2010, amended 2019] Management of second stage of labour 1.7.7 Do not routinely limit the duration of the second stage of labour in women with controlled hypertension. [2010, amended 2019] 1.7.8 Consider operative or assisted birth in the second stage of labour for women with severe hypertension whose hypertension has not responded to initial treatment. [2010, amended 2019] 1.8 Medical management of severe hypertension, severe pre-eclampsia or eclampsia in a critical care setting Anticonvulsants 1.8.1 If a woman in a critical care setting who has severe hypertension or severe pre-eclampsia has or previously had an eclamptic fit, give intravenous magnesium sulfate. [2010] 1.8.2 Consider giving intravenous magnesium sulfate to women with severe pre-eclampsia who are in a critical care setting if birth is planned within 1.8.3 Consider the need for magnesium sulfate treatment, if 1 or more of the following features of severe pre-eclampsia is present: ongoing or recurring severe headaches visual scotomata nausea or vomiting epigastric pain oliguria and severe hypertension progressive deterioration in laboratory blood tests (such as rising creatinine or liver transaminases, or falling platelet count). [2010, amended 2019] 1.8.4 Use the Collaborative Eclampsia Trial regimen for administration of : A loading dose of 4 g should be given intravenously over 5 to 15 minutes, followed by an infusion of 1 g/hour maintained for 24 hours. 