When the blood pressure exceeds 110 mm Hg diastolic or 180 mm Hg systolic, consideration should be given to lowering the blood pressure. Both hydralazine and labetalol may be given as an intermittent bolus or a continuous infusion with continuous blood pressure monitoring. Other agents that can be used include verapamil and nifedipine. Occasionally, unresponsive blood pressure requires the administration of a more potent agent, such as sodium nitroprusside, usually with central hemodynamic monitoring. The use of calcium channel blockers may help in the postpartum period.
Vaginal delivery is generally preferable to cesarean delivery.
Under appropriate circumstances, cervical ripening with prostaglandin E2 gel may be considered. In some cases, a seriously ill patient with an unfavorable cervix may need cesarean delivery rather than a long induction of labor. The decision must be based on the clinical circumstances. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference.