A small amount of aspirin a day could help certain groups of pregnant women keep a potentially serious and sometimes fatal condition at bay. The National Institute for Health and Clinical Excellence (NICE) says this is just one of a number of ways to help prevent and treat hypertension (high blood pressure) before, during and after pregnancy.
The condition is a leading cause of maternal death in the UK. A new guideline sets out a series of measures to help healthcare professionals including GPs, midwives and obstetricians care for women with, or at risk of, developing hypertension during their pregnancy. Hypertension in pregnancy includes the condition pre-eclampsia and is more common in first-time pregnancies. It can also have serious health implications – babies are more likely to be premature, stillborn or smaller than average and mothers are at an increased risk of developing high blood pressure later in life.
Key recommendations include:
• Advising pregnant women with a moderate to high risk of developing pre-eclampsia to take a low dose (75 mg) of aspirin each day from the twelfth week of pregnancy until birth to reduce their risk of developing the condition.
• Informing women with hypertension who are planning a pregnancy that angiotensinconverting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs), which can be used to control hypertension in non-pregnant women, can increase the risk of congenital abnormalities if taken during pregnancy and discuss more suitable forms of antihypertensive treatment.
• Offering women with hypertension or preeclampsia a package of care including admission to hospital, treatment, measurement of blood pressure, testing for protein in their urine and blood tests.
• Carrying out ultrasounds to assess fetal growth, amniotic fluid volume and Doppler ultrasound to measure blood flow in the umbilical artery at different stages of pregnancy (as stated in the guideline) and according to the seriousness of hypertension in the expectant mother.
• Offering birth to women with pre-eclampsia after 34 weeks, but only once their blood pressure is under control, after discussions with specialists and, if needed, a course of antenatal steroids has been given to the woman to help mature the baby’s lungs before birth.
• Advising women who have had pre-eclampsia to keep or achieve a healthy BMI before their next pregnancy.
The guideline also informs mothers-to-be that restricting their salt intake and taking dietary supplements such as magnesium or antioxidants (vitamins C and E) will not help prevent hypertension during pregnancy.
