Chronic Hypertension If controlled hypertension, not recommended to deliver before 38 weeks Changes if uncontrolled and especially if growth restriction found

Moving toward Delivery in GHTN/pre-e without severe features Deliver at 37 weeks Deliver at >34 weeks if: PROM, abnormal fetal tests, IUGR < 5%, concern for abruption

Preeclampsia with severe features Delivery expedited taking into account fetal maternal well being and gestational age > 34 w0d, expedite delivery after stabilizing mother If < 34 wks, can do in-hospital expectant management depending on maternal/fetal status Should be in a tertiary center

Steroids for Fetal Maturity Give corticosteroids and defer delivery for 48 hours if maternal and fetal conditions remain stable for women with severe preeclampsia and a viable fetus at 33 6/7 weeks or less of gestation

Delivery Route Vaginal delivery is recommended even with severe features C-section is indicated with seizures refractory to medication, severely elevated BP not responding to medications, and maternal or fetal compromise when delivery not imminent