Chronic essential and secondary hypertension in pregnancy

Hypertension is a relatively common complication of pregnancy, increasing in frequency in older women. It is not a contraindication to pregnancy, but should be fully investigated, correctable causes addressed and those with specific relevance for pregnancy identified. With close supervision and appropriate management, the majority of hypertensive pregnant women have successful outcomes. Ideally all women with chronic hypertension should be seen prior to a planned pregnancy, for explanation and discussion of the significance, risks and treatment plan and for adjustment of antihypertensive medication as necessary. Those charged with the antenatal and perinatal care of the patient should be familiar with the expected physiological changes in pregnancy and of the risks and benefits of any treatment given. Close communication among the patient, her obstetrician and consultant physician will ensure the most appropriate treatment and facilitate decisions regarding admission to hospital, timing and mode of delivery, and management issues in the early postpartum period.