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Severe hypertension in pregnancy rarely treated to guideline
Prevalence of Persistent Severe Hypertension and Rates of Treatment Among Pregnant Patients in the Prehospital Setting
Prehospital Emergency Care · 2026-10-30 · Added 31 October 2026
A US national EMS dataset study of 39,546 responses for pregnant patients beyond 20 weeks found persistent severe hypertension in 3.1%, of whom only 0.8% received guideline-adherent treatment with both magnesium and an antihypertensive.
- Study type
- Cohort
- Design
- Retrospective observational cohort (2024 ESO Data Collaborative)
- Participants
- 39,546 EMS scene responses for pregnancy beyond 20 weeks
- Main finding
- Persistent severe hypertension in 3.1% (1,234/39,546); of those, 6.2% received magnesium only, 1.5% an antihypertensive only, and 0.8% both magnesium and an antihypertensive
- Caveat
- US retrospective dataset, and treatment rates pre-date the 2025 ACOG-NAEMSP prehospital guideline
- Bottom line
- Hypothesis-generating
Why it matters in Australia (Medium relevance). Magnesium for pre-eclampsia sits in nearly every Australian formulary, but the paired antihypertensive the new US guideline wants is carried by only a handful of services, so the full pathway doesn't transfer yet.
Learning goal
Recognise persistent severe hypertension in pregnancy as a prehospital risk requiring timely treatment decisions.
More
- Topic: Obstetrics
- Daily scan: 31 October 2026
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