In plain words
Severe-range hypertension is blood pressure high enough to put a mother at immediate risk of stroke, seizure, or organ damage. In pregnancy and the postpartum period, it is a reading of 160 or higher on the top number, or 110 or higher on the bottom number, that lasts or is confirmed on a repeat check. It is most often seen with , but it can happen after birth without other signs. Many mothers who have it feel well, which is one reason blood pressure is checked. Some have a severe headache, vision changes, or pain under the ribs. The care team treats it as an emergency, with medicines to lower blood pressure and, when preeclampsia with severe features is found, to lower the risk of seizures. Mothers are usually taught the warning signs before they go home.
The deeper version
Severe-range hypertension is defined by ACOG as systolic pressure of at least 160 or diastolic pressure of at least 110 mm Hg, sustained for 15 minutes (Committee Opinion 767, 2019). In the postpartum period it is managed as a hypertensive emergency under ACOG Practice Bulletin 222 (2020): urgent evaluation, rapid antihypertensive treatment from a named short list of agents compatible with breastfeeding within about an hour, magnesium sulfate for seizure prophylaxis where preeclampsia with severe features is diagnosed, and laboratory assessment. The Alliance for Innovation on Maternal Health severe hypertension bundle provides a parallel pathway for hospital teams. Postpartum hypertension can be a feature of , and headache with severe-range readings is treated as higher risk.
Where it comes up
- Headaches after birthPostpartum: Your Body
- Postpartum preeclampsia: the warning signsPostpartum: Your Body
- Postpartum warning signs: the one-page listPostpartum: Your Body
What mothers here say about severe-range hypertension
No one has posted under this term yet.
Sources
- American College of Obstetricians and Gynecologists — Practice Bulletin 222: Gestational hypertension and preeclampsia, 2020
- American College of Obstetricians and Gynecologists — Committee Opinion 767: Emergent therapy for acute-onset, severe hypertension during pregnancy and the postpartum period, 2019
- Alliance for Innovation on Maternal Health — AIM Patient Safety Bundle: severe hypertension in pregnancy and the postpartum period