Priority 9 from the Blood Pressure in Pregnancy PSP

UNCERTAINTY: What is the best way to manage pregnancy hypertension (including optimal antenatal and postnatal antihypertensive medication and optimal timing of delivery)?  (JLA PSP Priority 9)
Overall ranking 9
JLA question ID 0099/9
Explanatory note Not available for this PSP
Evidence

Oral antihypertensive therapy for severe hypertension in pregnancy and postpartum: a systematic review.Firoz T, Magee LA, MacDonell K, Payne BA, Gordon R, Vidler M, von Dadelszen P; Community Level Interventions for Pre-eclampsia (CLIP) Working Group.BJOG. 2014 Sep;121(10):1210-8; discussion 1220. doi: 10.1111/1471-0528.12737. Epub 2014 May 16. Review.PMID:24832366

Prevention and treatment of postpartum hypertension.Magee L, von Dadelszen P.Cochrane Database Syst Rev. 2013 Apr 30;(4):CD004351. doi:10.1002/14651858.CD004351.pub3. Review.PMID:23633317

Planned early delivery versus expectant management for hypertensive disorders from 34 weeks gestation to term. Cluver C, Novikova N, Koopmans CM, West HM. Cochrane Database Syst Rev. 2017 Jan 15;1:CD009273. doi: 10.1002/14651858.CD009273.pub2. Review.Interventionist versus expectant care for severe pre-eclampsia between 24 and 34 weeks' gestation. Churchill D, Duley L, Thornton JG, Jones L. Cochrane Database Syst Rev. 2013 Jul 26;(7):CD003106. doi: 10.1002/14651858.CD003106.pub2. Review.
Lancet. 2009 Sep 19;374(9694):979-988. doi: 10.1016/S0140-6736(09)60736-4. Epub 2009 Aug 3.

Health Research Classification System category Reproductive health and childbirth
Extra information provided by this PSP
Original uncertainty examples What are the most effective medicine's and considerations to control high high blood pressure, pre and post delivery. ~ What is the most effective antihypertensive for control of postnatal hypertension ~ Best post delivery medication to use as add on treatment ~ Can pre eclampsia be controlled more effectively post pregnancy( medics struggled to find the right drugs to use on me as I deteriorated after my baby was born)? ~ Do women with mildly elevated blood pressure alone really need an induction of labour? ~ When is the mothers well being more important than the baby? ~ Early induction etc? ~ When is the mothers well being more important than the baby? ~ Early induction etc? ~ Do women with mildly elevated blood pressure alone really need an induction of labour? ~ When is the mothers well being more important than the baby? ~ Early induction etc? ~ When is the mothers well being more important than the baby? 
Submitted by 76 women, 3 who knew a person/relative/friend with pregnancy hypertension, 20 healthcare, 3 other, 2 researcher
PSP information
PSP unique ID 0099
PSP name Blood Pressure in Pregnancy
Total number of uncertainties identified by this PSP.

50 (To see a full list of all uncertainties identified, please see the detailed spreadsheet held on the JLA website)

Date of priority setting workshop 20 June 2019