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Hypertension in multiple pregnancy

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

NICE have stated guidance regarding the management of blood pressure in multiple pregnancy (1):

  • measure blood pressure and test urine for proteinuria to screen for hypertensive disorders at each antenatal appointment in twin and triplet pregnancies as in routine antenatal care

Advise pregnant women with more than 1 moderate risk factor for pre-eclampsia to take 75 mg to 150 mg of aspirin daily from 12 weeks until the birth of the baby. Factors indicating moderate risk are:

  • nulliparity
  • age 40 years or older
  • pregnancy interval of more than 10 years
  • body mass index (BMI) of 35 kg/m2 or more at first visit
  • family history of pre-eclampsia
  • multi-fetal pregnancy

** at the time of this NICE guidacne (April 2024) this drug did not have UK marketing authorisation for this indication. Informed consent should be obtained and documented


For full details see NICE (April 2024). Twin and triplet pregnancy


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