Hypertension in pregnancy

Aim to maintain BP under 140/90mmHg. Women who are known to have hypertension or are on treatment for high blood pressure will be referred for Home Blood pressure monitoring in pregnancy by the community midwife. NHS Lothian provides these monitors with information leaflets and education to eligible women throughout pregnancy and till 10 days postnatal.

Who can refer:

• GP
• Community midwife
• Patient self-referral

Who to refer:

Women with hypertensive disorders in pregnancy should be cared for by an obstetric consultant. It would usually be recommended for them to give birth in an obstetric-led unit such as the labour ward at RIE and SJH.

Consider the possibility of pre-eclampsia or eclampsia in pregnancy if a woman develops any of the following:

• Severe headaches, increasing frequency, unrelieved by analgesia
• Visual problems
• Persistent new epigastric or RUQ pain
• Vomiting
• Hypertension >140/90
• Proteinuria
• Sudden onset SOB due to pulmonary oedema
• Sudden swelling of hands, face or feet
• Seizure

If concerns about pre-eclampsia or very high BP (160/110mHg) – urgent referral to Obstetric Triage Assessment at Royal Infirmary (0131 242 2657) or labour ward at St John’s Hospital (01506 524125), or contact the Obstetric Registrar On Call via Switchboard at Royal Infirmary / St John’s Hospital.

How to refer:

For referral to an obstetric consultant, please contact the community midwifery team for your area who can advise on who the locality consultant is and provide their secretaries details.

For emergencies and urgent care, patients can come without calling.

However, if possible, the patient should phone for advice first. There is a midwife who is available 24/7:

Royal Infirmary of Edinburgh 0131 242 2657

St John’s Hospital 01506 524125

NICE guideline 133: Hypertension in Pregnancy- Diagnosis and Management – 25^th June 2019

Overview | Hypertension in pregnancy: diagnosis and management | Guidance | NICE