Anesthesia Considerations 

Postpartum

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• Measure BP @ peak postpartum BP (3-7 days postpartum)

• Evaluate women w/ postpartum HTN for preeclampsia

  • HTN & preeclampsia can arise de novo postpartum

• Consider continuing antiHTN tx postpartum

• Treat severe postpartum HTN to keep BP <160 /110 mmHg in short term

  • Keep BP <140/90 mmHg in long term

• Anti HTN agents generally acceptable with breastfeeding:

  • Nifedipine XL

  • Labetalol

  • Methyldopa

  • Captopril, enalapril

• No NSAIDs postpartum if HTN difficult to control, evidence of kidney dysfxn, or low plts

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Reference: Magee LA, Smith GN, Bloch C, et al. Guideline No. 426: Hypertensive Disorders of Pregnancy: Diagnosis, Prediction, Prevention, and Management. J Obstet Gynaecol Can. 2022;44(5):547-571.e1. doi:10.1016/j.jogc.2022.03.002