> Hypertension in pregnancy – fetal Monitoring

1.7 Assistance intrapartum

women with disorders hypertensive during pregnancy should receive advice and treatment in line with “Care of the intrapartum management and delivery of care to women in labor (NICE guideline 55), unless it differs specifically from the recommendations in this guideline.

1.7.1 blood Pressure

1.7.1.1 During birth, measure blood pressure:

    the

  • in women with hypertension or mild to moderate
  • the

  • continually in women with severe hypertension.

1.7.1.2 Continue the use of anti-hypertensive antenatale during childbirth.

1.7.2 Monitoring the hematological and biological

1.7.2.1 Determine the needà to test hematological and biochemical during childbirth in women with mild or moderate hypertension using the same criteria for the period antenatale even if it is considered analgesia regional.

1.7.3 Care during epidural analgesia

1.7.3.1 do Not preload women who have severe pre-eclampsia with fluids intravenous prior to the establishment of epidural analgesia low-dose and analgesia analgesia in the spinal epidural space.

1.7.4 Management of the second phase of the labor

1.7.4.1 Not restrict routine the duration of the second stage of labour:

    the

  • in women with stable hypertension (mild or moderate
  • the

  • if the blood pressure is controlled within the limits of the target in women with severe hypertension.

1.7.4.2 you like to Recommend the birth operating in the second stage of labour for women with severe hypertension whose hypertension has not responded to initial treatment.

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