Intrapartum Postpartum Hypertension Infographic-Intrapartum Postpartum Hypertension Infographic

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This information sheet from the Emergency Nurses Association (ENA) provides guidelines for managing intrapartum or postpartum hypertension. It is important to note that this information is for informational purposes only and should not replace the judgment of a medical practitioner.<br /><br />In the case of acute-onset, severe hypertension (systolic ≥ 160 mm Hg or diastolic ≥ 110 mm Hg), a healthcare provider should be notified immediately. Severe hypertension that persists for 15 minutes or more is considered a hypertensive emergency. This can occur during the prenatal, intrapartum, or postpartum stages, up to six weeks postpartum.<br /><br />Treatment should be initiated within 30-60 minutes of confirming severe hypertension to reduce the risk of maternal stroke. First-line antihypertensive agents, such as immediate-release oral nifedipine, hydralazine, or labetalol, should be administered as directed by a healthcare provider. It is important not to lower the blood pressure too quickly.<br /><br />Frequent blood pressure measurements should be taken and recorded, and 1:1 nursing care should be considered. If severe hypertension persists, other antihypertensive medications may be necessary. Consultation with maternal-fetal medicine or critical care subspecialists may be required.<br /><br />Symptoms of hypertension, such as headache or visual changes, in patients of child-bearing age should be assessed immediately. Other symptoms, such as epigastric/abdominal pain and swelling of the hands and feet, should also be monitored. Close fetal monitoring and treatment protocols should be initiated as appropriate.<br /><br />It is recommended to talk to a healthcare provider about possible admission to a critical care unit for closer observation if needed.<br /><br />These guidelines are based on the recommendations of The American College of Obstetricians and Gynecologists, Committee on Obstetric Practice. The information provided is subject to change as advances emerge and recommendations change, and ENA assumes no liability for any reliance on the information contained herein.

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