[2010] Fluid balance and volume expansion 1.8.11 Do not use volume expansion in women with severe pre-eclampsia unless hydralazine is the antenatal antihypertensive. [2010] 1.8.12 In women with severe pre-eclampsia, limit maintenance fluids to 80 ml/ hour unless there are other ongoing fluid losses (for example, Caesarean section versus induction of labour 1.8.13 Choose mode of birth for women with severe hypertension, severe pre- eclampsia or eclampsia according to the clinical circumstances and the woman's preference. [2010] Referral to critical care 1.8.14 Refer women with severe hypertension or severe pre-eclampsia to the appropriate critical care setting using the criteria in table 4. [2010] Table 4 Clinical criteria for choice of critical care level care Severe pre-eclampsia and needing ventilation care Step-down from level 3 or severe pre-eclampsia with any of the following complications: eclampsia HELLP syndrome haemorrhage hyperkalaemia severe oliguria coagulation support intravenous antihypertensive treatment initial stabilisation of severe hypertension evidence of cardiac failure abnormal neurology care Pre-eclampsia with hypertension Ongoing conservative antenatal management of severe preterm hypertension Step-down treatment after the birth 1.9 Antihypertensive treatment during the postnatal period, including during breastfeeding 1.9.1 Advise women with hypertension who wish to breastfeed that their treatment can be adapted to accommodate breastfeeding, and that the need to take antihypertensive medication does not prevent them from 1.9.2 Explain to women with hypertension who wish to breastfeed that: antihypertensive medicines can pass into breast milk most antihypertensive medicines taken while breastfeeding only lead to very low levels in breast milk, so the amounts taken in by babies are very small and would be unlikely to have any clinical effect most medicines are not tested in pregnant or breastfeeding women, so disclaimers in the manufacturer's information are not because of any specific safety concerns or evidence of harm. 