What monitoring protocols should be followed for pregnant patients diagnosed with hypertension to ensure maternal and fetal safety?

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Posted: 16 August 2025Updated: 16 August 2025 Guideline-Aligned (High Confidence) Clinically Reviewed
Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX

For pregnant patients diagnosed with hypertension, conduct regular fetal ultrasound assessments for growth, amniotic fluid volume, and umbilical artery doppler velocimetry at diagnosis and at specified intervals: every 2 to 4 weeks for gestational hypertension, and at 28, 32, and 36 weeks for chronic hypertension .

Carry out cardiotocography at diagnosis of pre-eclampsia or severe gestational hypertension, and only repeat if clinically indicated .

In women with pre-eclampsia or severe gestational hypertension, perform ultrasound for fetal growth, amniotic fluid assessment, and umbilical artery doppler velocimetry at diagnosis, with subsequent scans every 2 to 4 weeks depending on findings .

Monitor maternal blood pressure hourly during labour in women with hypertension, and every 15 to 30 minutes until blood pressure is less than 160/110 mmHg in cases of severe hypertension .

Assess for symptoms of pre-eclampsia at each antenatal visit, including proteinuria testing via dipstick, and quantify if positive, using albumin:creatinine ratio or protein:creatinine ratio .

Perform repeat biochemical and haematological tests (platelet count, transaminases, serum creatinine) 48-72 hours postpartum or after step-down from critical care, and repeat if abnormal .

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