SASH Study - Sonographic Assessment for Severe Hypertension in Pregnancy (SASH)

• Group 1: All pregnant women (under the care of the Maternal-Fetal Medicine physicians or Faculty Medical Center physicians with MFM involvement) experiencing a hypertensive emergency (sustained systolic blood pressure > 160 mmHg or sustained diastolic blood pressure > 110 mmHg {or both} on at least two consecutive occasions 15 minutes apart). All participants must be over the age of 18 and capable of consenting to the study (conscious, with capacity for medical decision making for themselves).
• Group 2: All asymptomatic pregnant women who are undergoing routine obstetric ultrasound evaluations at any gestational age who elect to undergo cardiovascular sonographic assessment for research purposes at no cost. All participants must be over the age of 18 and capable of consenting to the study (conscious, with capacity for medical decision making for themselves).

Inclusion Criteria:

• For symptomatic women, those presenting to triage, admitted to Labor & Delivery or any of the above units who are at risk for developing a hypertensive emergency will be identified by the OBGYN resident staff or attending physicians as "at risk" for hypertensive emergency as based on current chronic hypertension, gestational hypertension, or preeclampsia). Women presenting with or developing new onset hypertensive emergency can be offered recruitment as well given that the performance of these sonographic measures will not interfere with initiating antihypertensive therapy.

Exclusion Criteria:

• Age < 18 years
• Non-pregnant
• Without the capacity to provide informed written consent
• Non-English speaking without the ability to obtain a hospital interpreter
• Known atrial-ventricular heart block
• History of heart failure
• Moderate-to-Severe bronchial asthma
• Allergy to the medications used as part of regular care treatment of the patient population
• Lack of intravenous IV access
• Concurrent use of antihypertensive medications
• Congenital heart disease in the mother