Blood pressure (BP) is measured and urinalysis is routinely performed during each prenatal visit.[31]US Preventive Services Task Force. Hypertensive disorders of pregnancy: screening. Sep 2023 [internet publication].
https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/hypertensive-disorders-pregnancy-screening
The frequency of visits increases as the pregnancy progresses or if BP is increasing.
At each visit, maternal and fetal evaluation are undertaken, including complete blood count, liver and renal function tests, and quantitative urinary protein testing (spot testing where available, or 24-hour urine collection), as needed.[1]American College of Obstetricians and Gynecologists. ACOG practice bulletin no. 222: gestational hypertension and preeclampsia. Jun 2020 [internet publication].
https://www.acog.org/clinical/clinical-guidance/practice-bulletin/articles/2020/06/gestational-hypertension-and-preeclampsia
http://www.ncbi.nlm.nih.gov/pubmed/32443077?tool=bestpractice.com
[5]National Institute for Health and Care Excellence. Hypertension in pregnancy: diagnosis and management. Apr 2023 [internet publication].
https://www.nice.org.uk/guidance/ng133
[65]Sep S, Smits L, Prins M, et al. Prediction tests for recurrent hypertensive disease in pregnancy, a systematic review. Hypertens Pregnancy. 2010 Jan;29(2):206-30.
http://www.ncbi.nlm.nih.gov/pubmed/20102284?tool=bestpractice.com
Placental growth factor (PlGF)-based testing should be performed on one occasion.[5]National Institute for Health and Care Excellence. Hypertension in pregnancy: diagnosis and management. Apr 2023 [internet publication].
https://www.nice.org.uk/guidance/ng133
[28]National Institute for Health and Care Excellence. PLGF-based testing to help diagnose suspected preterm pre-eclampsia. Jul 2022 [internet publication].
https://www.nice.org.uk/guidance/dg49
In women under 37 weeks' gestation with hypertension, outpatient management with close supervision is acceptable. Women with severe hypertension (systolic BP ≥160 mmHg and/or diastolic BP ≥110 mmHg), or who are symptomatic, require admission for antihypertensive therapy.[5]National Institute for Health and Care Excellence. Hypertension in pregnancy: diagnosis and management. Apr 2023 [internet publication].
https://www.nice.org.uk/guidance/ng133