A comparison of current British and American practice in the management of hypertension in pregnancy

Abstract

Summary A detailed questionnaire on the management of hypertension in pregnancy was sent to three groups of clinicians practising in the United States of America: obstetricians in private practice, obstetricians in academic departments and nephrologists in academic departments. Their responses were compared with those obtained previously from obstetricians practising in the United Kingdom. The responses from American obstetricians in academic and private practice were very similar, but these responses differed from those of the nephrologists. The American and British obstetricians adopted similar approaches to the treatment of hypertension in pregnancy. The main differences were with respect to the choice of drugs employed in the treatment of fulminating pre-eclampsia and eclampsia, when the Americans tend to use magnesium sulphate and the British prefer diazepam to barbiturates as anticonvulsants and epidural anaesthesia to control hypertension in labour.