Expert Consensus on Hypertension and Pregnancy

While gestational hypertension is a frequent pathology that develops during pregnancy (1 in 10 pregnancies on average), the healthcare field still isn’t equipped to manage it well. In France, there are no formal care pathways that would specify the role of each health professional while also accounting for the term of pregnancy. This explains why decisions are often made late. In practice, management will differ depending on whether the woman is already known to be hypertensive, whether it is a new pregnancy with a history of gestational vascular disease, or whether it is a young primiparous woman (pregnant with her first child) who previously had normal blood pressure. Medical practitioners have recurring questions on treatment modalities for hypertension during pregnancy, blood pressure targets, the role of ambulatory monitoring, follow-up care modalities, aspirin prescription, postpartum period management (breastfeeding, contraception, check-ups to schedule). In addition, the link between preeclampsia and cardiovascular outcome remains poorly addressed in remote follow-up care for these at-risk women. Obstetrical history of obstetrics should now be part of the routine questions for any at-risk woman. The potential seriousness of gestational hypertension for the mother and child, the risk of recurrence in a subsequent pregnancy, and the risk of the mother developing chronic hypertension or another cardiovascular complication at a later date, spur us to standardize our medical practices.
To this end, the French Society of Hypertension and the French National College of Gynecologists and Obstetricians have developed 22 recommendations to help professionals improve management of hypertension during pregnancy. The messages are clear, simple and practical. They cover diagnosis, treatment, preeclampsia and the postpartum period and introduce innovations in follow-up care such as a follow-up care booklet, a preconception consultation and an information and presentation consultation after delivery. The goal of this consensus is to guide all health professionals involved in the pregnancy care pathway while also being understandable for the general public.

The French Society of Hypertension has established a partnership with Women’s Cardiovascular Healthcare Foundation to optimize cardiovascular prevention for women around pregnancy, a key hormone stage. This consensus on hypertension and pregnancy allows us to alert, anticipate and act by giving practical recommendations and highlights the importance of preconception and postpartum consultations, including those some time after the delivery, as well as during all follow-up care for these high-risk pregnancies.
Publishing the HTA and Pregnancy Consensus on our website (About Us > Publications menu) should further increase the visibility of the consensus and its use by all health professionals and also by women themselves.

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