Blood pressure >140/90 present before the pregnancy or starting before 20 weeks.
Pregnant women with chronic hypertension should continue to follow the lifestyle modifications for controlling
hypertension such as:
- No alcohol
- Regular moderate exercise, brisk walking for 30 minutes at least 3 times a week
- Smoking cessation.
Health worker should:
- Ask mother about foetal movements at each visit
- Aim for BP <140/90 mmHg
- Consider labour if BP is persistently ≥160/90 mmHg, pregnancy ≥37 weeks gestation, and if there is maternal or foetal compromise, e.g. poor SFH growth
Switch chronic antihypertensive medication to or start
- Methyldopa 250 mg 8 hourly, increase as necessary, max 500 mg 6 hourly
- Nifedipine 20-40 mg every 12 hours
If not controlled or any sign of pre eclampsia: refer to hospital
- ACE inhibitors, ARBs are contraindicated in pregnancy
- Avoid beta blockers and diuretics