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TREATMENT OF ACUTE SEVERE HYPERTENSION
(SBP > 160 MM HG or DBP > 105 MM Hg)
IN PREECLAMPSIA [1]
Hydralazine 5 mg IV or 10 mg IM every 20 minutes until diastolic
blood pressure is 90 to 100 mm Hg or maximum total dose of 20 mg IV or 30 mg IM . Once blood pressure is
controlled repeat as needed every 3 hours.
Labetalol 20-mg intravenous bolus dose followed by 40 mg if not effective
within 10 minutes; then, 80 mg every 10 minutes to maximum total dose of 220 mg.
Avoid giving to women with asthma, congestive heart failure, or suspected
cocaine intoxication. If hypertension is not responding to hydralazine or labetalol and/or there are
clinical findings of hypertensive encephalopathy then consider :
Sodium nitroprusside 0.25mcg/kg/min to a maximum dose of 5 mcg/kg/min.
Fetal cyanide poisoning may occur if used more than 4 hours.
REFERENCES:
1. Report
of the National High Blood Pressure Education Program Working Group on High
Blood Pressure in Pregnancy.
Accessed: 9/9/06
2. Shoemaker CT, Meyers M. Sodium nitroprusside for
control of severe hypertensive disease of pregnancy: a case report and
discussion of potential toxicity. Am J Obstet Gynecol 1984;149:171–3. |
