Dovepress Pre-eclampsia SBP > 160 mmHg SBP < 180 mmHg or DBP < 140 mmHg Maintenance treatment Nicardipine 1–6 mg/h or Intravenous labetalol 5–20 mg/h After 30 minutes: Assessment of the therapeutic efficacy and tolerance SBP > 160 mmHg or DBP > 120 mmHg Bitherapy Nicardipine 6 mg/h associated to : Labetalol 5–20 mg/h or Clonidine 15–40 µg/h (if CI to β−) Side effects (cephalalgia, palpitations, etc) Bitherapy 1. Reduction of nicardipine and 2. Association with: Labetalol 5–20 mg/h or Clonidine 15–40 µg/h (if CI to β−) SBP > 180 mmHg or DBP > 140 mmHg Initiation of treatment Intravenous nicardipine 0.5–1 mg bolus then 30 min of 4 to 7 mg perfusion 140 < SBP < 160 mmHg 100 < DBP < 120 mmHg Maintenance treatment nicardipine 1–6 mg/h or labetalol 5–20 mg/h SBP < 140 mmHg DBP < 100 mmHg Reduction or cessation of the treatment After 30 minutes and then every hour: reassessment of the therapeutic effect Figure 1 Algorithm for antihypertensive treatment of pre-eclampsia.22 Note: MBP = [systolic BP + 2 × diastolic BP]/3. Abbreviations: MBP, mean blood pressure; Ci, contraindication; SBP, systolic blood pressure; DBP, diastolic blood pressure. The risk of recurrence of pre-eclampsia during a subsequent pregnancy has to be considered. This risk is estimated to be less than 10% for all cases of pre-eclampsia,37 but is greater when pre-eclampsia is discovered before 28 weeks. The relative risk is 15 if pre-eclampsia occurs at 20–33 weeks, 10 at 33–36 weeks, and 8 after 37 weeks.37 Three months after delivery, screening for underlying renal or hypertensive disease may be requested by the patient’s primary physician. Such screening is intended to check for normalization of blood pressure values and disappearance of proteinuria, and if abnormalities persist, a referral should be made to a nephrologist or a hypertension expert to determine the cause. This examination is impor- tant because pre-eclampsia may unmask previously undiagnosed systemic or kidney disease or thrombophilia. It should include a specific set of questions, blood pressure measurement, a clinical examination looking for signs of autoimmune conditions, and a urinary dipstick test. Testing for antiphospholipid antibodies is recommended after severe pre-eclampsia. The search for hereditary thrombophilia by assays for protein C and S, antithrombin III, and a test for resistance to activated protein C is recommended in the case Vascular Health and Risk Management 2011:7 submit your manuscript | www.dovepress.com Dovepress 471