Gestational Hypertension: No Severe Features
Description General measures Medicine treatment Referral O13 DESCRIPTION Hypertension occurring for the first time at ≥ 20 weeks' gestation with no proteinuria. GENERAL MEASURES May be managed without admission < 38 weeks' gestation, provided no proteinuria. Review the following on a weekly basis: BP weight urine analysis height of fundus (every two weeks) foetal heart rate and movements Educa
Description
General measures
Medicine treatment
Referral
O13
DESCRIPTION
Hypertension occurring for the first time at ≥ 20 weeks' gestation with no proteinuria.
GENERAL MEASURES
- May be managed without admission < 38 weeks' gestation, provided no proteinuria.
- Review the following on a weekly basis:
- BP
- weight
- urine analysis
- height of fundus (every two weeks)
- foetal heart rate and movements
- Educate on signs requiring urgent follow-up (headache, epigastric pain, visual disturbances, vaginal bleeding etc.).
MEDICINE TREATMENT
- Methyldopa, oral, 250 mg 8 hourly.
- Titrate to a maximum dose: 750 mg 8 hourly.
- When using iron together with methyldopa, ensure that iron and methyldopa are not taken concurrently.
LoE:IIIb20
REFERRAL
- All patients with gestational hypertension at 38 weeks for delivery.
- Pre-eclampsia (all levels of severity).
- Poor control of hypertension.
- Hypertension with severe features (urgent referral).
Standard Treatment Guidelines and Essential Medicines List for South Africa, Primary Healthcare, 2025-9_Version 1.0_26 March 2026
Chapter 6: Obstetrics and Gynaecology_6.4.2.2 Gestational Hypertension: No Severe Features