Hypertensive Disorders in Pregnancy

2017 ◽  
Author(s):  
Kavitha Vellanki ◽  
Susan Hou
Keyword(s):  
Blood Pressure ◽  
Organ Damage ◽  
The United States ◽  
Blood Pressure Target ◽  
Maternal Complications ◽  
Hypertension In Pregnancy ◽  
Hypertensive Disorders ◽  
Few Data ◽  
In Pregnancy ◽  
New Onset

Hypertensive disorders are the second leading cause of maternal mortality in the United States. Hypertension in pregnancy is defined as blood pressure greater than or equal to 140 mm Hg systolic or greater than or equal to 90 mm Hg diastolic, measured on at least two separate occasions. Preeclampsia, as per the new guidelines, is characterized by the new onset of hypertension and either proteinuria or other end-organ dysfunction, more often after 20 weeks of gestation in a previously normotensive pregnant woman. New-onset proteinuria is not required for diagnosis of preeclampsia if there is evidence of other end-organ damage—a change from previous classifications. Although no screening test has yet proven accurate enough to predict preeclampsia, the use of a combination of the serologic factors seems promising. There are few data to support any specific blood pressure target in pregnancy. Although there is a general consensus on treating severe hypertension in pregnancy, there is a difference of opinion on treating mild to moderate hypertension in pregnancy. Avoiding uteroplacental ischemia and minimizing fetal exposure to adverse effects of medications are as important as avoiding maternal complications from high blood pressure during pregnancy. This review contains 2 figures, 4 tables, and 73 references.

Hypertensive Disorders in Pregnancy

2017 ◽  
Author(s):  
Kavitha Vellanki ◽  
Susan Hou
Keyword(s):  
Blood Pressure ◽  
Organ Damage ◽  
The United States ◽  
Blood Pressure Target ◽  
Maternal Complications ◽  
Hypertension In Pregnancy ◽  
Hypertensive Disorders ◽  
Few Data ◽  
In Pregnancy ◽  
New Onset

Hypertensive disorders are the second leading cause of maternal mortality in the United States. Hypertension in pregnancy is defined as blood pressure greater than or equal to 140 mm Hg systolic or greater than or equal to 90 mm Hg diastolic, measured on at least two separate occasions. Preeclampsia, as per the new guidelines, is characterized by the new onset of hypertension and either proteinuria or other end-organ dysfunction, more often after 20 weeks of gestation in a previously normotensive pregnant woman. New-onset proteinuria is not required for diagnosis of preeclampsia if there is evidence of other end-organ damage—a change from previous classifications. Although no screening test has yet proven accurate enough to predict preeclampsia, the use of a combination of the serologic factors seems promising. There are few data to support any specific blood pressure target in pregnancy. Although there is a general consensus on treating severe hypertension in pregnancy, there is a difference of opinion on treating mild to moderate hypertension in pregnancy. Avoiding uteroplacental ischemia and minimizing fetal exposure to adverse effects of medications are as important as avoiding maternal complications from high blood pressure during pregnancy. This review contains 2 figures, 4 tables, and 73 references.

Hypertensive Disorders in Pregnancy

2017 ◽  
Author(s):  
Kavitha Vellanki ◽  
Susan Hou
Keyword(s):  
Blood Pressure ◽  
Organ Damage ◽  
The United States ◽  
Blood Pressure Target ◽  
Maternal Complications ◽  
Hypertension In Pregnancy ◽  
Hypertensive Disorders ◽  
Few Data ◽  
In Pregnancy ◽  
New Onset

Hypertensive disorders are the second leading cause of maternal mortality in the United States. Hypertension in pregnancy is defined as blood pressure greater than or equal to 140 mm Hg systolic or greater than or equal to 90 mm Hg diastolic, measured on at least two separate occasions. Preeclampsia, as per the new guidelines, is characterized by the new onset of hypertension and either proteinuria or other end-organ dysfunction, more often after 20 weeks of gestation in a previously normotensive pregnant woman. New-onset proteinuria is not required for diagnosis of preeclampsia if there is evidence of other end-organ damage—a change from previous classifications. Although no screening test has yet proven accurate enough to predict preeclampsia, the use of a combination of the serologic factors seems promising. There are few data to support any specific blood pressure target in pregnancy. Although there is a general consensus on treating severe hypertension in pregnancy, there is a difference of opinion on treating mild to moderate hypertension in pregnancy. Avoiding uteroplacental ischemia and minimizing fetal exposure to adverse effects of medications are as important as avoiding maternal complications from high blood pressure during pregnancy. This review contains 2 figures, 4 tables, and 73 references.

Hypertensive disorders

ESC CardioMed ◽  
2018 ◽  
pp. 2872-2874
Author(s):  
Renata Cifkova
Keyword(s):  
Blood Pressure ◽  
Laboratory Tests ◽  
Medical Complications ◽  
Pharmacological Management ◽  
Hypertension In Pregnancy ◽  
Hypertensive Disorders ◽  
Hypertensive Disorders In Pregnancy ◽  
Diagnosis Of Hypertension ◽  
In Pregnancy

Hypertensive disorders in pregnancy are the most common medical complications affecting 5–10% of pregnancies worldwide. This chapter discusses the following topics: diagnosis of hypertension, definition and classification of hypertension in pregnancy, additional laboratory tests, management of hypertension in pregnancy, pharmacological management of hypertension in pregnancy, delivery induction, blood pressure postpartum and lactation, and prognosis after pregnancy.

scholarly journals Hypertension in pregnancy: Pathophysiology and treatment

2019 ◽  
Vol 7 ◽  
pp. 205031211984370 ◽  
Author(s):  
Stephanie Braunthal ◽  
Andrei Brateanu
Keyword(s):  
Gestational Hypertension ◽  
Severe Hypertension ◽  
Organ Damage ◽  
Morbidity And Mortality ◽  
Perinatal Morbidity ◽  
Hypertensive Disorders Of Pregnancy ◽  
Hypertension In Pregnancy ◽  
Hypertensive Disorders ◽  
In Pregnancy ◽  
The Ideal

Hypertensive disorders of pregnancy, an umbrella term that includes preexisting and gestational hypertension, preeclampsia, and eclampsia, complicate up to 10% of pregnancies and represent a significant cause of maternal and perinatal morbidity and mortality. Despite the differences in guidelines, there appears to be consensus that severe hypertension and non-severe hypertension with evidence of end-organ damage need to be controlled; yet the ideal target ranges below 160/110 mmHg remain a source of debate. This review outlines the definition, pathophysiology, goals of therapy, and treatment agents used in hypertensive disorders of pregnancy.

scholarly journals A Comprehensive Review of Hypertension in Pregnancy

2012 ◽  
Vol 2012 ◽  
pp. 1-19 ◽  
Author(s):  
Reem Mustafa ◽  
Sana Ahmed ◽  
Anu Gupta ◽  
Rocco C. Venuto
Keyword(s):  
The United States ◽  
Diagnostic Tools ◽  
Hypertension In Pregnancy ◽  
Hypertensive Disorders ◽  
Drug Classes ◽  
Hypertensive Disorders In Pregnancy ◽  
Short And Long Term ◽  
Potential Risks ◽  
In Pregnancy

Hypertension is the most common medical disorder encountered during pregnancy. Hypertensive disorders are one of the major causes of pregnancy-related maternal deaths in the United States. We will present a comprehensive update of the literature pertinent to hypertension in pregnancy. The paper begins by defining and classifying hypertensive disorders in pregnancy. The normal vascular and renal physiological changes which occur during pregnancy are detailed. We will summarize the intriguing aspects of pathophysiology of preeclampsia, emphasizing on recent advances in this field. The existing diagnostic tools and the tests which have been proposed for screening preeclampsia are comprehensively described. We also highlight the short- and long-term implications of preeclampsia. Finally, we review the current management guidelines, goals of treatment and describe the potential risks and benefits associated with various antihypertensive drug classes. Preeclampsia still remains an enigma, and the present management focuses on monitoring and treatment of its manifestations. We are hopeful that this in depth critique will stimulate the blossoming research in the field and assist practitioners to identify women at risk and more effectively treat affected individuals.

Hypertensive disorders

ESC CardioMed ◽  
2018 ◽  
pp. 2872-2874
Author(s):  
Renata Cifkova
Keyword(s):  
Blood Pressure ◽  
Laboratory Tests ◽  
Medical Complications ◽  
Pharmacological Management ◽  
Hypertension In Pregnancy ◽  
Hypertensive Disorders ◽  
Hypertensive Disorders In Pregnancy ◽  
Diagnosis Of Hypertension ◽  
In Pregnancy

Hypertensive disorders in pregnancy are the most common medical complications affecting about 10% of pregnancies worldwide. This chapter discusses the following topics: diagnosis of hypertension, definition and classification of hypertension in pregnancy, additional laboratory tests, management of hypertension in pregnancy, pharmacological management of hypertension in pregnancy, delivery induction, blood pressure postpartum and lactation, and prognosis after pregnancy.

Use of Nifedipine in the Hypertensive Diseases of Pregnancy

1994 ◽  
Vol 28 (12) ◽  
pp. 1371-1378 ◽  
Author(s):  
Anne C. Levin ◽  
Paul L. Doering ◽  
Randy C. Hatton
Keyword(s):  
Blood Pressure ◽  
English Language ◽  
Antihypertensive Agents ◽  
Organ Damage ◽  
Initial Therapy ◽  
Current Data ◽  
Chronic Hypertension ◽  
Hypertension In Pregnancy ◽  
Uteroplacental Blood Flow ◽  
In Pregnancy

OBJECTIVE: To review the available data about the use of nifedipine to treat hypertension in pregnancy. DATA SOURCES: All English language cases and studies published after 1984 and indexed in MEDLINE, Excerpta Medica, and BIOSIS PREVIEWS under the headings nifedipine, hypertension in pregnancy, uteroplacental blood flow, maternal/fetal hemodynamics, preeclampsia, and pregnancy outcome. MAIN OUTCOME MEASURES: The primary outcome indicators included the safety and antihypertensive efficacy of nifedipine in pregnancy; the effects of nifedipine on maternal/fetal hemodynamics; and the effect, if any, of nifedipine on perinatal outcome. CONCLUSIONS: Traditional drug therapy choices for hypertension in pregnancy continue to be hydralazine for acute reduction of blood pressure and methyldopa for the management of chronic hypertension. Current data indicate that nifedipine is an appropriate second-line antihypertensive medication in pregnancy, but more clinical trials are needed before it can be considered an appropriate choice for initial therapy. As do other antihypertensive agents, nifedipine provides maternal benefit by lowering blood pressure and reducing the risk of cerebral hemorrhage and end-organ damage. However, perinatal benefit of nifedipine remains to be established.

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