Pre-eclampsia and gestational hypertension are associated with later chronic hypertension, ischaemic heart disease and stroke, and the association persists for decades. The postnatal check is the natural point to hand this over.
The discharge summary should name the diagnosis clearly so that the next clinician recognises it as a risk factor, and the woman should know why her blood pressure, weight, lipids and glucose deserve checking regularly. In future pregnancies the history also raises her risk of recurrence and usually warrants low-dose aspirin from early pregnancy under local guidance.
- Write the hypertensive diagnosis clearly in the discharge summary for the primary care clinician.
- Check blood pressure again at the postnatal visit and arrange ongoing review if it stays raised.
- Explain to the woman that the history raises her long-term heart and stroke risk.
- Advise early booking in a future pregnancy so preventive aspirin can be considered.
Why it matters
The pregnancy is often the first and only warning of later cardiovascular disease.
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