Hypertensive disorders of pregnancy: A review and updates for the emergency physician.

Hypertensive disorders of pregnancy (HDPs) are a spectrum of disease contributing to immediate and lasting morbidity and mortality in pregnant patients and neonates globally. With decreasing access to obstetric care in the United States, an expected increase in patients will seek care in emergency departments. Consequently, emergency physicians will likely assume a greater share of initial care and resuscitation of patients with HDPs. HDPs represent a spectrum of disease including gestational hypertension; chronic hypertension in pregnancy; pre-eclampsia; superimposed pre-eclampsia; Hemolysis, Elevated Liver enzymes and Low Platelets (HELLP) syndrome; and eclampsia. This is a review of the current literature and guidelines of HDPs, including updated HDP diagnostic criteria, diagnostic testing, and initial management. Given the growing understanding of lasting cardiovascular effects of HDPs, emergency physicians should carefully consider the long-term impacts of HDPs, even after delivery. Appropriate recognition, treatment, and coordination of care are essential to optimizing care of pregnant patients who present to the emergency department.