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[Hypertensive disorders in pregnancy].

P Dürig1, C Ferrier, H Schneider

  • 1Universitäts-Frauenklinik, Inselspital Bern.

Therapeutische Umschau. Revue Therapeutique
|November 5, 1999
PubMed
Summary

Hypertension in pregnancy, including preeclampsia, affects 5-10% of pregnancies. While mild cases may not require treatment, severe preeclampsia necessitates prompt delivery to ensure maternal and fetal well-being.

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Area of Science:

  • Obstetrics and Gynecology
  • Maternal-Fetal Medicine
  • Cardiology

Context:

  • Hypertension in pregnancy complicates 5-10% of gestations.
  • Preeclampsia, a severe form of hypertension with proteinuria, is a leading cause of maternal and perinatal mortality.
  • Accurate classification and management are crucial for optimizing pregnancy outcomes.

Purpose:

  • To review the classification, diagnosis, and management of hypertension in pregnancy.
  • To highlight the risks associated with preeclampsia and its severe forms like HELLP-syndrome and eclampsia.
  • To discuss current therapeutic strategies, including antihypertensive therapy, magnesium sulfate prophylaxis, and the role of aspirin and heparin.

Summary:

  • Hypertension in pregnancy is categorized into chronic hypertension, preeclampsia, superimposed preeclampsia, and transient hypertension.
  • Preeclampsia and superimposed preeclampsia are dangerous multiorganic diseases, while transient hypertension is generally benign.
  • Management strategies vary from watchful waiting for mild chronic hypertension to urgent delivery for severe preeclampsia and eclampsia, with magnesium sulfate as key prophylaxis.

Impact:

  • This review provides a comprehensive overview of hypertensive disorders in pregnancy, aiding clinicians in diagnosis and management.
  • Understanding the nuances of different hypertensive conditions can lead to improved maternal and fetal outcomes.
  • Highlights the importance of postpartum follow-up to identify pre-existing conditions.

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