CG107 Migrated

7/23/2019 CG107 Migrated

http://slidepdf.com/reader/full/cg107-migrated 1/50

!K K: !K K:

C>> G>

G>: 25 AGG 2010

..G=/G/107

© NICE 2010. All rights reserved.

http://nice.org.uk/guidance/cg107

http://nice.org.uk/guidance/cg107



CC

"G ......................................................................................................................................................................... 4

- ........................................................................................................................................................ 6

$K >............................................................................................................................... 7

1 G ............................................................................................................................................................................ 9

DS........................................................................................................................................................................................... 9

1.1 G = KH K...................................................................................... 10

1.2 & K I K ............................................................................................ 12

1.3 A G KH K ................................................................... 15

1.4 & K I > K..................................................................................... 15

1.5 & K I ->........................................................................................................... 19

1.6 F> ........................................................................................................................................................................ 24

1.7 "G ....................................................................................................................................................................... 26

1.8 &> H K H -> > ............ 27

1.9 B............................................................................................................................................................................. 30

1.10 AH >>I-G GK .................................................................................... 31

2 G ........................................................................................................................ 34

3 "> .............................................................................................................................................................. 35

4 ...................................................................................................................................... 36

4.1 G = KH K ..................................................................................... 36

4.2 A G KH K ................................................................... 36

4.3 !>> > I I > K............................. 37

4.4 I I ->............................................................................................................... 37

4.5 AKH .................................................................................................................. 38

5 H G>................................................................................................................................ 39

5.1 FG>> G>............................................................................................................................................................................... 39

5.2 '" G> .................................................................................................................................................... 39

6 > "CE G................................................................................................................................................. 40

Hypertension in pregnancy (CG107)

© NICE 2010. All rights reserved. of 50



7 G> ................................................................................................................................................. 41

AJ A: G> DH> G "CE < .................................................. 42

AJ B: G> HI >................................................................................................................. 44

AJ C: >........................................................................................................................................... 45

AJ D: DG ..................................................................................................................................... 46

C G>............................................................................................................................................... 48

AG G> .......................................................................................................................................................... 49





G> 35.

"G"G

!KH G K G I I -J K K

K, I I H> I- K >

K.

!KH G K K = I K. A>G

> $ ($) H >>, K K

> G > $. !KH GK K > G> G> > K. A $ GK -

H > K I G KH . A GK

$ 1 20 (5%) I I H -> > I

H . & >K, >- G I I

K G K H >, G> K

> HG> =.

!KH > K = K. " $ > >K

, 1 20 (5%) >> IG > >K G I I

->. G -> H>> G>;

1 250 (0.4%) I S K I>> H 34 I= G

-> 8P10% >> G> KH . !> I

I H -> H .

>>-->- (>K G > I >>

) , I 20P25% 14P19% I I

-> > > I .

> G I I H -> >

KH G K1

. !IH, G

I K (>G

G KH ) K I I K.

>> G>

KH G K >, G > . "





>G I I K I I H

H I K > K K.

>> G>

KH G K >, G > . "

>G I I K I I H

H I K > K K.

G> G I>> G G' GK G (C)

I HG> . DG I G> G>

> I G K > = IQ

> J D.

G> G I K H $ =

G G>, H G G. &K G

H > G S>>K I, T G

J>G G. > G = I =.

" G>, G = I = (*) K H $ =

G G G> (AGG 2010). "

G> G.

1K> C>> K> (2006) H

->/>; > "G !> C>> EJ>> (2008) A>

. "CE >> G> 62. : > "G !> C>> EJ>>.



http://www.nice.org.uk/guidance/cg62




- -

G> H I I KH

K.

G> = G I' . I

KH K G> H GK =

G , I > >. " I

H K = , > > G> >>I D

!>' H &> CK A.

G I > > I >. " G>

G K H- I > I' . , I H G , G> G>G>>K . " G> >

> > I > G K>, K > >,

> I = E>.



http://www.dh.gov.uk/en/DH_103643


http://www.dh.gov.uk/en/SocialCare/Deliveringsocialcare/MentalCapacity

http://www.dh.gov.uk/en/SocialCare/Deliveringsocialcare/MentalCapacity





$$K >K >

G = G = KHKH K K

AH I = -> = 75 * >K 12 I= G>

K. = I K >>I:

KH G HG K

=K

GG G K >GG K >

K

K 1 K 2

K. 1.1.2.11.1.2.1

& K I & K I KK

>> I I = -H LK (ACE) ""

>= (AB):

= > > G =

G K

G KH I > >

> K, K > K. 1.2.1.11.2.1.1

" I I G> K = > G

>I 150/100 !. 1.2.3.11.2.3.1

A G A G KHKH K K

G - H GK :

G K . 1.3.1.11.3.1.1

& K I > & K I > KK

I I > K = H

>, , G > G, G >

> 1. 1.4.1.31.4.1.3





& K I ->& K I ->

I I -> = H >,

, G > G, G >

> 2. 1.5.1.21.5.1.2

CG> G> G I' > (>,

>> >>) > > >H 34 I= I

I ->. 1.5.2.21.5.2.2

>> I I H -> > HI > HI

(6P8 I= ). 1.5.3.101.5.3.10

AH >>I-G AH >>I-G GK GK

>> I I -> = H>:

> K GG K G 1 8 (13%)

G 1 2 (53%)

-> GG K G G 1 6 (16%)

-> GG K G 1 4 (25%) -> I > K H ->, !E K >

> 34 I=, G 1 2 (55%) >

28 I=. 1.10.4.21.10.4.2





11 GG

>>I G H>> H. G>> G> H >

H G H> G.

D%/

F G G>, >>I S >K:

C C KK K = H 20 I=

I >K = KH I K

H. " K K >K.

E>E> HG>H I ->.

!E K!E K >K, >H >H LK >I >> G.

> > KK I K 20 I= IG S

G.

->-> I K 20 I= I S G.

HH -> -> -> I H K / I K, /

> / >> .

S GS G S 1.3.1.3

" , G> DH> G (D) S >, H

K > I > G >>I:

&> &> KK > > G 90P99 !, K> > G

140P149 !.

&& KK > > G 100P109 !, K> > G

150P159 !.

HH KK > > G 110 ! , K> > G

160 ! .

G G > G K 'A>

' ("CE >> G> 62).











" G>, >H >K G G >G K

>H .

1.1 R%$# % + /& %%% $/$% %!#

1.1.11.1.1 K ->K ->

1.1.1.1 I G> I = H

> > K J K ->.

K >G:

H

> I H, G >G T K

H <G >I

H

G I>> , .

'A> ' ("CE >> G> 62).

1.1.21.1.2 A>> A>>

1.1.2.1 AH I = -> = 75 * >K

12 I= G> K. = I K

>>I:

KH G HG K

=K

GG G K >GG K >

K

K 1 K 2

K.







1.1.2.2 AH I I = ->

= 75 * >K 12 I= G> K. F

= :

S K

40 K >

K H> 10 K

K J (B&") 35 =/2

S H

>K K ->

G>> K.

1.1.31.1.3 G> G>

1.1.3.1 D G >>I H KH G K:

J

G

>I >G> I .

1.1.41.1.4 G> G>G> G>

1.1.4.1 D >>I G> >>K I H

KH G K:

G

>

J (H C E)

S > >> >

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1.1.51.1.5 DD

1.1.5.1 D > G K >>K H

> K ->.

1.1.61.1.6 K>K>

1.1.6.1 AH , J I= I = KH

G K G> >K I (

'A> ', "CE >> G> 62).

1.2 M!!%% /& %!# #/# %%/

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'!K: K G> K ' ("CE >> G>

34) (> K '!K: >> K K G>' "CE

>> G> 127), G> S>>K G>.

1.2.11.2.1 -K H-K H

1.2.1.1 >> I I = -H LK (ACE)

"" >= (AB):

= > > G =

G K

G KH I > >

> K, K > K.

1.2.1.2 KH I = ACE AB

K (>K I 2 I= K S

K) >H.

1.2.1.3 >> I I = >L:

K = > >K >

> G = G K

G KH I > >

> K, K > K.







1.2.1.4 >> I I = KH ACE ,

AB >L > H H>> I

= > > I G .

1.2.21.2.2 DD

1.2.2.1 EG I I K = K G

= >I, K G GG G >, G

G > G. ( '!K:

K G> K ' "CE >> G>

34 > K '!K: >> K K

G> M"CE >> G> 127N.)

1.2.31.2.3 KK

1.2.3.1 " I I G> K = >

G >I 150/100 !.

1.2.3.2 D I I G> K

>I > > G >I 80 !.

1.2.3.3 I I - K

K ( J>, =K ) I =

> G >I 140/90 !.

1.2.3.4 I I K K >

> KH .

1.2.3.5 I I K KH

-J , - S> K.

1.2.41.2.4 A> G>A> G>

1.2.4.1 " I I K, G> > >

G> HG> I K.





1.2.51.2.5

1.2.5.1 D I I K I > G

>I 160/110 !, I IG KH ,

37 I=.

1.2.5.2 F I I K I > G >I 160/

110 ! 37 I=, I IG KH ,

> > G> I

I .

1.2.5.3 I I K H K,

G ( G) >.

1.2.61.2.6 > > HH, ,

1.2.6.1 " I I K I H H , G >

G:

>K S 2 K

> I K 3 K 5

>>>K KH .

1.2.6.2 " I I K I H H , = >

G >I 140/90 !.

1.2.6.3 " I I K I H H :

G > KH .

HI >- KH 2 I=

.

1.2.6.4 " I = K>Q

K G

K, I 2 K KH

I I = > K.





1.2.6.5 I I K > HI >

HI (6P8 I= ) I -K .

1.3 A%% /& /%! %%% $/$% /& %!#

1.3.1.1 G - H GK

: G K .

1.3.1.2 " G - H G G

G> 1+ , G GK :

24-G G >> GK G.

1.3.1.3 D S G GK : 30 /> H> 24-G G >> G> I

300 .

1.3.1.4 24-G G >> G GK G, G>

H>G > >.

1.4 M!!%% /& %!# %!/! %%/

1.4.11.4.1 KK

1.4.1.1 " I I > K G>> G> G

K K > > I

KH .

1.4.1.2 " I I > K, = G >>I =

G >

>>I-G:

G>>K

40 K >

K H> 10 K

>K K ->

G>> K





B&" 35 =/2

>

HG K -> > K

-J HG>

-J =K .

1.4.1.3 I I > K =

H >, , G > G,

G > > 1.

> 1 & K I > > 1 & K I > KK

D D

KK

&> &> KK

(140/90 149/ (140/90 149/

9999 !)!)

&& KK

(150/100 159/ (150/100 159/

109109 !)!)

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(160/110(160/110 ! !

))

A A

>>

(G> >

G 159/

109 ! >I)

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Q

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=:

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80P100 !

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80P100 !

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G >

150 !

&G&G

>>

GG

I=

A > I I= A > G

K





GG

A H G

G -

H GK

:

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G -

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-

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1.4.1.4 >K I I > K KH

>>> - S> I, G

I K. A>H >G K>Q

Q.

1.4.1.5 " I H G H > K,

H>K >> >, G > G

G I I=>K K G I=>K > .

1.4.1.6 " I I > K 32 I=, =

-> ( 1.1.1.1), G > G G I I=>K.

1.4.1.7 D > > K.

1.4.21.4.2

1.4.2.1 D 37 I= I I > K

I > G >I 160/110 !, I IG

KH .

1.4.2.2 F I I > K I > G >I

160/110 ! 37 I=, I IG KH ,

, > > G>

I I .





1.4.2.3 I I K H > K

G ( G) >.

1.4.31.4.3 > > HH, ,

1.4.3.1 " I I > K I H H , G >

G:

>K S 2 K

> I K 3 K 5

>>>K KH .

1.4.3.2 " I I > K I H H :

G G > KH

G KH > G >> >I 140/

90 !

G KH > G >> >I 130/80 !.

1.4.3.3 " I = K>Q

> K, I

2 K .

1.4.3.4 F I I > K I = KH

H H , KH >

G 149/99 !.

1.4.3.5 > I I > K I H H

GK >G >>

>>I:

I I>> H >>I-G , >G > HI

GK > G

> G

> K > G HI.





1.4.3.6 I I H > K

KH 2 I= GK , >

HI.

1.4.3.7 I I H > K > HI

> HI (6P8 I= ).

1.4.3.8 I I H > K I >>

KH > HI

(6P8 I= ) > K.

1.5 M!!%% /& %!# %-%#!!

1.5.11.5.1 KK

1.5.1.1 A I I -> G>. A G>

K > >

KH K.

1.5.1.2 I I -> = H

>, , G > G,

G > > 2.

> 2 & K I ->> 2 & K I ->

D D

KK

&> &> KK

(140/90 149/ (140/90 149/

9999 !)!)

&& KK

(150/100 159/ (150/100 159/

109109 !)!)

HH KK

(160/110(160/110 ! !

))

A A

>>





> >>>Q

S->

=:

> >G I

80P100 !

K> >

G >

150 !

> >>>Q

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=:

> >G I

80P100 !

K> >

G >

150 !

&G&G

>>GG

A > G K A > G K & G

K, >>G

GG

D

GS

G

D

GS

G

D

GS

G

B> B> & G

>>I I

I=: =K G,>>K, G>> >

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>G

& G

>>I

I=: =KG, >>K, G>>

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, >G

& G

>>I

I=: =KG, >>K, G>>

> G,

, >G

1.5.1.3 >K I I -> KH

>>> - S> I, G

I K. A>H >G K>Q

Q.

1.5.21.5.2

1.5.2.1 & K I I -> HH>K ( ,

> -K >HK K) G> 34 I=.

1.5.2.2 CG> G> G I' >

(>, >> >>) > > >H

34 I= I I ->.





1.5.2.3 CG> G> I > > >

G .

1.5.2.4 I I -> 34 I=, G I

> G H

:

H K H> K

> > H> S G> > ( 1.5.22).

1.5.2.5 I I H -> I H K

34 I= I > G >> G

> ( ).

1.5.2.6 I I H -> I >

K 34+0

36+6

I= > > ,

= H>>K > H .

1.5.2.7 I 24P48 G I I H -> I

> K 37+0

I=.

1.5.31.5.3 > > HH, (>G , (>G

> > ))

B//$ B//$ % %%%

1.5.3.1 " I I -> I = KH

H H , G > G:

> G K I> I

> I K 3 K 5

> K G> > > G I > K 3P5.

1.5.3.2 " I I -> I = KH

H H , KH > G 150/

100 ! .





1.5.3.3 A= I I -> I H H G H

> G G.

1.5.3.4 " I I -> I = KH H

H , G > G:

> G K I> I

HK 1P2 K G 2 I= GK G> I

K.

1.5.3.5 F I I -> I H = KH

H H :

G > KH

G KH > G >> >I 140/

90 !

G KH > G >> >I 130/80 !.

1.5.3.6 " I = K>Q

->, I 2 K

.

1.5.3.7 I I -> I H H GK

>> >>I H :

K ->

> G, I IG , 149/99 ! >I

> G> > H.

1.5.3.8 > I I -> I H H

GK >G >> >>I:

I I>> H >>I-G , >G > HI

GK > G

> G





> K > G HI

>- K.

1.5.3.9 I I H -> >> KH

2 I= GK > HI.

1.5.3.10 >> I I H -> > HI >

HI (6P8 I= ).

1.5.3.11 I I H -> I >> KH

> HI (6P8 I= ) >

K.

H!%!//#! !$ "/#%#! // H!%!//#! !$ "/#%#! //

1.5.3.12 " I I H -> I > K,

-I > :

G >> G, G 48P72 G

-I

>> G, G G

G> > 48P72 G.

1.5.3.13 " > >> H G K I

> I I -> I H H ,

>> G, G G >>>K

> HI (6P8 I= ).

1.5.3.14 " > >> H >H K I I -> I H H ,

>> G, G G >>>K

.

1.5.3.15 " I I -> I H H , K G GK -

> HI (6P8 I= ).





1.5.3.16 " I I -> I H H H I

> >H> 2, G TG > I

> .

1.5.3.17 I I -> >> H G (1+ )

> HI (6P8 I= ) G HI 3

=K G >

> =K .

1.6 F%! //

1.6.11.6.1 C C KK

1.6.1.1 " I I K, K G G>G > I

TG H>G G>> K > H>K

I 28 30 I= I 32 34 I=. " G> >,

34 I=, G> I >>>K .

1.6.1.2 " I I K, >K K G K >

HK >.

1.6.21.6.2 &> &> > > KK

1.6.2.1 " I I > > K, K G G>G

> I TG H>G G>> K >

H>K S > 34 I=. " G> >,

34 I=, G> I >>>K .

1.6.2.2 " I I > > K, K G

G>G > I TG H>G G>>

K > H>K S 34 I=, G>

I >>>K .

1.6.2.3 " I I > > K, >K K G

K > HK >.





1.6.31.6.3 HH > > K ->K ->

1.6.3.1 CK G K H > K

->.

1.6.3.2 " HH H > K -

> >, K G >> >>I :

G>G > I TG H>G

G>> K > H>K.

1.6.3.3 " G> >> > > I I H >

K ->, G>K K

I=>K.

1.6.3.4 " I I H > K ->,

K K >>I G:

I > H

H> >

>

> .

1.6.3.5 " I I H > K ->,

G>K G>G > I TG H>G

G>> K > H>K HK 2 I=.

1.6.3.6 " G> K > I I H >

K -> >, >> G> .

1.6.3.7 F I I H > K ->, I

> >G >> >>I:

G GG >

> I G> H





I G I > G> =

> I G> .

1.6.41.6.4 = -> = ->

1.6.4.1 CK G G>G > I TG H>G

G>> K > H>K I 28 30 I= (

> 2 I= HG > > 28 I=)

4 I= > I I HG:

H ->

-> 34 I=

-> I K I I I > 10 >

G

>> G.

1.6.4.2 " I I = -> ( 1.1.2.2), >K K G

K > HK >.

1.7 I!! #!%

I KH G K G> H H >

I '"G : >HK I >G' ("CE >>

G> 55), G> S>>K G>.

1.7.11.7.1 B> GB> G

1.7.1.1 DG >G, G > G:

G>K I I > K

G>>K I I H K.

1.7.1.2 CG G > KH G >G.







1.7.21.7.2 !>> > !>> >

1.7.2.1 D >> > G >G

I I > K G

> H > > .

1.7.31.7.3 C G GC G G> >> >

1.7.3.1 D > I I H H -> I HG TG

> >I- G> > > G>

>.

1.7.41.7.4 & >G& >G

1.7.4.1 D G>K > G >G:

I I > > K

> G >> I I I H

K.

1.7.4.2 H >G I I

H K I K >

.

1.8 M%$#! !!%% /& %%% %%/ / %%% %-%#!! !

##! #!% %

1.8.11.8.1 AAHG>HG>

1.8.1.1 " I > I H K H -

> HG>K > S, H HG G

G>*.

1.8.1.2 C H HG G G>* I I H -

> I > > I 24 G.

1.8.1.3 " G G>* , G >>I G

H ->:





H K G

> K G I >>I:

K H

> I H, G >G T K

H <G >I H

>>

>G (R3 )

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!E K

>> G >> >I 100 J 109

>

> >H LK (A A H 70 G/>).

1.8.1.4 C>>H E> >2

G G>*:

> 4 G> H HG>K H 5 G, >>I K

G 1 /G 24 G

G LG G> I G 2P4 H H 5 G.

1.8.1.5 D G L, K >K => >H G

G>* I I >.

1.8.21.8.2 AAKHKH

1.8.2.1 I I H K I > G

K >K I >>I:

>>>Q

(> HG)

K>L (HG)

Q (>).





1.8.2.2 " I I H K I > ,

:

G > G >>

K H I G

K .

1.8.2.3 C G G 500 > K>> TG

S HG K>L > .

1.8.2.4 " I I H K I > , = K>

> G >I 150 ! > > G I 80 100 !.

1.8.31.8.3 C > >G GC > >G G

1.8.3.1 " >=>K I 7 K I I ->:

H I * 12 GG>>K 24 G I

I 24 34 I=

H I * 12 GG>>K 24 G

I I 35 36 I=.

1.8.41.8.4 C !E KC !E K

1.8.4.1 D G J !E

K.

1.8.51.8.5 F>G > HF>G > H>G >G JJ

1.8.5.1 D G H>G J I I H -> G>

K>L > KH.

1.8.5.2 " I I H ->, > TG 80 >/G

G> TG > ( J>, ).





1.8.61.8.6 C HC HG G >GG G >G

1.8.6.1 C I I H K, H -

> > >> G I'

.

1.8.71.8.7 " " > > >> > >HH>>

1.8.7.1 I I H K H -> >

> G >>I 3

:

H> 3

H -> H>

H> 2

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>:

P >

P !E K

P

P K=>

P H >G

P G> G

P HG KH

P > > H K

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P > G>K

H> 1

P -> I > K

P HH > H

K

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