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VRGLXPGLHWVOHVVWKDQP(TGQRWEHXVHGIRUPDQaging chronic hypertension in pregnancy.

Quality of evidence:/RZ
Strength of recommendation:4XDOLHG
 )RUZRPHQZLWKFKURQLFK\SHUWHQVLRQZKRDUHDFFXVWRPHGWRH[HUFLVLQJDQGLQZKRP%3LVZHOOFRQWUROOHG
it is recommended that moderate exercise be continued
during pregnancy.
Quality of evidence:/RZ
Strength of recommendation:4XDOLHG
 )RU SUHJQDQW ZRPHQ ZLWK SHUVLVWHQW FKURQLF K\SHUWHQsion with systolic BP of 160 mm Hg or higher or diastolic
%3RIPP+JRUKLJKHUDQWLK\SHUWHQVLYHWKHUDS\LV
recommended.
Quality of evidence: Moderate
Strength of recommendation: Strong
 )RUSUHJQDQWZomen with chronic hypertension and BP
less than 160 mm Hg systolic or 105 mm Hg diastolic and
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they not be treated with pharmacologic antihypertensive therapy.
Quality of evidence:/RZ
Strength of recommendation: QualLHG
For pregnant women with chronic hypertension treated
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and 80 mm Hg diastolic and 160 mm Hg systolic and 105
mm Hg diastolic.
Quality of evidence:/RZ
Strength of recommendation:4XDOLHG
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K\SHUWHQVLRQ ZKR UHTXLUH SKDUPDFRORJLF WKHUDS\ ODEHWDOROQLIHGLSLQHRUPHWK\OGRSDDUHUHFRPPHQGHGDERYH
all other antihypertensive drugs.
Quality of evidence: Moderate
Strength of recommendation: Strong
 )RUZRPHQZLWKXQFRPSOLFDWHGFKURQLFK\SHUWHQVLRQLQ
SUHJQDQF\WKHXVHRIDQJLRWHQVLQFRQYHUWLQJHQ]\PHLQKLELWRUVDQJLRWHQVLQUHFHSWRUEORFNHUVUHQLQLQKLELWRUV
and mineralocorticoid receptor antagonists is not recommended.
Quality of evidence: Moderate
Strength of recommendation: Strong
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VOL. 122, NO. 5, NOVEMBER 2013

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mineralocorticoid receptor antagonists is not recomPHQGHGXQOHVVWKHUHLVDFRPSHOOLQJUHDVRQVXFKDVWKH
presence of proteinuric renal disease.
Quality of evidence:/RZ
Strength of recommendation:4XDOLHG
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greatly increased risk of adverse pregnancy outcomes
(history of early-onset preeclampsia and preterm deOLYHU\DWOHVVWKDQZHHNVRIgestation or preecODPSVLDLQPRUHWKDQRQHSULRUSUHJQDQF\LQLWLDWLQJWKH
administration of daily low-dose aspirin (6080 mg) beJLQQLQJLQWKHODWHUVWWULPHVWHULVVXJJHVWHG
Quality of evidence: Moderate
Strength of recommendation:4XDOLHG
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of aspirin to prevent preeclampsia indicates a small reduction
in the incidence and morbidity of preeclampsia and reveals no
evidence of acuteULVNDOWKRXJKORQJWHUPIHWDOHHFWVFDQQRW
be excluded. The number of women to treat to have a theraSHXWLFHHFWLVGHWHUPLQHGE\SUHYDOHQFH,QYLHZRIPDWHUQDO
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ULVNLVMXVWLHG

 )RUZRPHQZLWKFKURQLFK\SHUWHQVLRQWKHXVHRIXOWUDsonography to screen for fetal growth restriction is suggested.

Quality of evidence:/RZ
Strength of recommendation:4XDOLHG
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ZRPHQZLWKFKURQLFK\SHUWHQVLRQIHWRSODFHQWDODVVHVVPHQWWRLQFOXGHXPELOLFDODUWHU\'RSSOHUYHORFLPHWU\DV
an adjunct antenatal test is recommended.
Quality of evidence: Moderate
Strength of recommendation: Strong
 )RU ZRPHQ ZLWK FKURQLF K\SHUWHQVLRQ FRPSOLFDWHG E\
issues such as tKHQHHGIRUPHGLFDWLRQRWKHUXQGHUO\LQJ
PHGLFDO FRQGLWLRQV WKDW DHFW IHWDO RXWFRPH RU DQ\
HYLGHQFHRIIHWDOJURZWKUHVWULFWLRQDQGVXSHULPSRVHG
SUHHFODPSVLDDQWHQDWDOIHWDOWHVWLQJLVVXJJHVWHG
Quality of evidence:/RZ
Strength of recommendation:4XDOLHG
 )RUZRPHQZLWKFKURQLFK\SHUWHQVLRQDQGQRDGGLWLRQDO
PDWHUQDORUIHWDOFRPSOLFDWLRQVGHOLYHU\EHIRUH
weeks of gestation is not recommended.
Quality of evidence: Moderate
Strength of recommendation: Strong
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Executive Summary: Hypertension in Pregnancy

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