Looking for evidence around induction for high blood pressure

[jezza1234]

Hi everyone,

Just wondering if someone could point me towards some evidence around induction for high bp (not pre-eclampsia)? Doc wants to induce at 39-40 weeks but I can’t find any official guidance supporting this. Thanks!

I don't know of any research, it's just in case of PE developing. Baby is full term at 37wk so fine to deliver after this point.
I had our 1st induced due to high bp at 39+3 (delivered 39+6), not my favourite birth but wasn't too bad.

Both of mine were induced over 20 years ago for high BP. I took the advice of my doctor, and found out later that he'd had a horrible situation with a woman and baby a couple of weeks previously, when HBP had been minimised. This made him ultra cautious with me. Didn't mind, didn't want to take risks either.

Why not ask our consultant? They’ll be able to provide references easily.

I don't know any official guidance but I was induced last year for high blood pressure with no other markers for pre-eclampsia.

Pretty sure it was a 'better safe than sorry' scenario in case pre-eclampsia develops.

www.nice.org.uk/guidance/ng133/chapter/Recommendations#management-of-gestational-hypertension

Here is an article explaining why it is beneficial, @jezza1234 www.eurekalert.org/pub_releases/2009-08/l-iol073109.php

Thanks everyone. @Greybeardy my doctor suggested RCOG but there’s no specific guidance there, it just points to the NIce guidance. @CovidCorvid the only reference in the Nice Guidance is “For women with gestational hypertension whose blood pressure is lower than 160/110 mmHg after 37 weeks, timing of birth, and maternal and fetal indications for birth should be agreed between the woman and the senior obstetrician. [2010, amended 2019]”. @Midlandsmum23 yes the HYPITAT study is the main piece of evidence I could find, which is interesting as it shows relatively small absolute risk reduction- around 12% and that includes people with pre-eclampsia. @Alarae yes I think it’s a better safe than sorry argument - I’m not averse to it in principle, just prefer to understand the reasoning behind it.

There used to be rcog guidance but that’s been super ceded by the nice guidance....plus I think it was more about just pre eclampsia. Which suggests the dr who mentioned rcog guidance isn’t very au fait with current guidance.

The reasoning behind it is that higher blood pressure can caused reduced placental Doppler flow ....we see it more with poorly controlled pre eclampsia but it happens with general hypertension as well. So can in some cases cause fetal growth restriction and worst case still birth.

You could ask about a scan to check growth and Doppler if this is their concern.

The NICE guidance is really wishy washy on what should be done or any reasons behind their (non) suggestion.

www.nice.org.uk/guidance/ng133/evidence/b-monitoring-gestational-hypertension-pdf-6836186127

This briefly discusses some of the evidence they looked at for the guideline.

@CovidCorvid that’s really helpful, thanks - actually had a growth scan and doppler today and all looking good so far thank goodness Will take a look through the evidence, and hopefully this thread helps others having the same convo with their doctors