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New NICE guideline update on Hypertension in pregnancy

We are pleased to announce the update of NICE guideline Hyptertension in pregnancy: diagnosis and management (NG133) developed by the National Guideline Alliance (NGA).

The guideline is a partial update of the 2010 NICE clinical guideline on Hypertension in pregnancy: diagnosis and management (CG107).

This guideline covers diagnosing and managing hypertension (high blood pressure), including pre-eclampsia, during pregnancy, labour, birth and immediately after birth.

It also includes advice for women with hypertension who wish to conceive and women who have had a pregnancy complicated by hypertension.

It aims to improve care during pregnancy, labour and birth for women and their babies.

Hypertension in pregnancy: diagnosis and management (NG133)

Read the new guideline update on the NICE website

Hypertensive disorders during pregnancy affect around 8-10% of all pregnant women and can be associated with substantial complications for the woman and the baby.

Women can have hypertension before pregnancy, or it can be diagnosed in the first 20 weeks (known as chronic hypertension), new onset of hypertension occurring in the second half of pregnancy (gestational hypertension) or new hypertension with features of multi-organ involvement (pre-eclampsia).

While the proportion of women with pregnancy hypertensive disorders overall appears to have stayed reasonably stable, maternal mortality from hypertensive causes has fallen dramatically: less than 1 woman in every million who gives birth now dies from pre-eclampsia.

There is consensus that introduction of the 2010 NICE evidence-based guidelines, together with the findings from the confidential enquiry into maternal deaths, has made a pivotal contribution to this fall in maternal mortality.

However, hypertension in pregnancy continues to cause substantial maternal morbidity, stillbirths and neonatal deaths, and perinatal morbidity.

Women with hypertension in pregnancy are also at increased risk of cardiovascular disease later in life.

The aim of the 2019 guideline is to present updated evidence-based recommendations, relevant to practising clinicians, while identifying outstanding areas of uncertainty that need further research.

There is a strong argument for uptake of these new guidelines into clinical practice, in order to minimise unnecessary variance and provide optimal care for women and their babies.

In doing this, low rates of maternal mortality should be maintained, and progress on reduction of maternal morbidity and perinatal morbidity and mortality can be pursued.

"Hypertension in pregnancy: diagnosis and management (update)" [NG133] is available on the NICE website from Tuesday 25 June 2019:
https://www.nice.org.uk/guidance/ng133

 

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