After pre-eclampsia or gestational hypertension, blood pressure commonly rises again between the third and sixth day after birth, as fluid shifts back into the circulation. Many women have gone home by then. Postpartum eclampsia and stroke cluster in this window.
Plan blood pressure checks in the first week, tell women which symptoms should bring them back — severe headache, visual disturbance, breathlessness — and review the need for antihypertensives rather than stopping them at discharge.
- Arrange a blood pressure check within the first postpartum week after any hypertensive pregnancy.
- Tell women that a severe headache or visual change after birth needs same-day review.
- Review antihypertensive doses as pressure falls rather than stopping them abruptly.
- Do not treat a normal reading at discharge as the end of the risk.
Why it matters
The highest postpartum readings often come after the woman has left hospital.
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