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Hypertension in pregnancy (gestational HTN & pre-eclampsia)

A Canadian clinical summary of hypertension in pregnancy (gestational htn & pre-eclampsia), with source-attributed priorities and explicit jurisdiction boundaries.

JurisdictionCanada
Source check2026-08-20
Clinical reviewiatroX editorial team 路 Clinical editorial review 路 reviewed 2026-08-20 路 due 2027-08-20
AudienceHealthcare professionals practising in Canada
This is an iatroX educational summary of named Canada sources, not an official guideline. It does not replace the complete source documents, local policy, specialist advice or clinical judgement. The evidence source is pan-Canadian, but formularies, funded access, referral routes, public-health directions and service availability remain provincial or territorial.

Source and scope

This summary is bounded to the recommendations, population and decisions covered by Guideline No. 426: Hypertensive Disorders of Pregnancy. Apply it with the current provincial or territorial pathway where implementation differs.
sources for this section:SOGC 426

Source-attributed clinical priorities

  • Confirm blood pressure with appropriate pregnancy technique and assess symptoms, urine protein, platelets, kidney and liver involvement and fetal wellbeing.
  • Distinguish chronic, gestational and preeclampsia phenotypes because prevention, surveillance and timing of birth differ.
  • Escalate severe hypertension or maternal or fetal severe features urgently and plan postpartum blood-pressure and cardiovascular follow-up.
  • Use correctly sized, repeated blood-pressure measurement and interpret it with gestational age and end-organ features.
sources for this section:SOGC 426

Practical assessment and management workflow

1
Confirm pregnancy dating and distinguish chronic, gestational and preeclamptic presentations.
2
Assess headache, visual symptoms, epigastric pain, edema, reflexes, urine protein, blood count, kidney and liver tests.
3
Coordinate fetal growth and wellbeing surveillance with maternal treatment through obstetric care.
4
Plan timing and place of birth and postpartum blood-pressure and long-term cardiovascular follow-up.
sources for this section:SOGC 426

Safety, red flags and urgent escalation

  • Severe hypertension, neurologic symptoms, pulmonary edema, abnormal liver or platelet findings or fetal concern needs urgent obstetric assessment.
  • Treat eclampsia as an emergency and follow the local magnesium and delivery protocol.
  • Avoid renin-angiotensin system blockers during pregnancy.
sources for this section:SOGC 426

Confirm the local pathway before acting

The evidence source is pan-Canadian, but formularies, funded access, referral routes, public-health directions and service availability remain provincial or territorial.
sources for this section:SOGC 426

Source and implementation boundary

Read this educational summary with the linked source, current Canadian product information where medicines are involved, and the applicable provincial or territorial pathway. Local formularies, reporting duties, referral routes and service availability can differ.
sources for this section:SOGC 426

Source documents

Use the linked source documents for complete recommendations, evidence grading, exclusions and implementation detail.

  1. Society of Obstetricians and Gynaecologists of CanadaGuideline No. 426: Hypertensive Disorders of Pregnancyaccessed 2026-08-20
    view source
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