First AD

Second AD

A. With preeclampsia and severe hypertension pre-delivery, parenteral nifedipine, labetalol, or hydralazine may be used. 

B. ACE inhibitor use during pregnancy has been associated with oligohydramnios, fetal renal dysfunction, and fetal death.

C. Labetalol may aggravate bradycardia and/or asthma.

Although secondary hypertension in pregnancy (from renal artery stenosis, for example) is rare—in 0.24% of pregnancies worldwide—it is under-diagnosed.1 Any pregnancy-related hypertension that does not fit into the 4 categories (

) may require additional testing and specialty consultation.

This reference presents a mistaken suspicion of preeclampsia in a woman with a pheochromocytoma.3

1. Vellanki SK, Mucsi I, Velagala S, et al. Hypertension and acute kidney injury during pregnancy. 

2. Barton JR, Sibai BM. Controversies regarding diagnosis and treatment of severe hypertension in poregnancy. 

3. Gonzalez MD, Rutecki G, Whittier FC. The problem patient: headaches in a pregnant woman with a history of preeclampsia. 

Hypertension Control in Pregnancy