Management of hypertensive disorders in pregnancy

Womens Health (Lond). 2014 Jul;10(4):385-404. doi: 10.2217/whe.14.32.

Abstract

Hypertensive disorders are the most common medical complication of pregnancy, with an incidence of 5-10%, and a common cause of maternal mortality in the USA. Incidence of pre-eclampsia has increased by 25% in the past two decades. In addition to being among the lethal triad, there are likely up to 100 other women who experience 'near miss' significant maternal morbidity that stops short of death for every pre-eclampsia-related mortality. The purpose of this review is to present the new task force statement and novel definitions, as well as management approaches to each of the hypertensive disorders in pregnancy. The increased understanding of the pathophysiology of hypertension in pregnancy, as well as advances in medical therapy to minimize risks of fetal toxicity and teratogenicity, will improve our ability to prevent and treat hypertension in pregnancy. Fetal programming and fetal origins of adult disease theories extrapolate the benefit of such therapy to future generations.

Keywords: HELLP syndrome; eclampsia; hypertension; pre-eclampsia; pregnancy; severe features.

Publication types

  • Review

MeSH terms

  • Antihypertensive Agents / therapeutic use
  • Female
  • Fetal Monitoring
  • HELLP Syndrome / diagnosis
  • HELLP Syndrome / therapy
  • Humans
  • Hypertension, Pregnancy-Induced / diagnosis*
  • Hypertension, Pregnancy-Induced / drug therapy*
  • Hypertension, Pregnancy-Induced / therapy
  • Incidence
  • Pre-Eclampsia / diagnosis
  • Pre-Eclampsia / therapy
  • Pregnancy
  • Pregnancy Outcome
  • Severity of Illness Index

Substances

  • Antihypertensive Agents