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Hypertension in pregnancy
Luigi Raio1, Daniele Bolla, Marc Baumann
1Department of Obstetrics and Gynecology, University of Bern, Bern, Switzerland.
Insights
Hypertension in pregnancy, particularly preeclampsia, significantly impacts maternal and infant health. Early recognition and management are crucial for reducing adverse outcomes and long-term cardiovascular risks.
Area of Science:
- Obstetrics and Gynecology
- Maternal-Fetal Medicine
- Cardiovascular Health in Pregnancy
Background:
- Hypertension in pregnancy is a major cause of perinatal mortality and morbidity.
- Preeclampsia, a severe form of hypertension, remains enigmatic despite extensive study.
- Rising rates of obesity and metabolic disorders will increase pregnancy complications.
Purpose of the Study:
- To review the impact of hypertensive disorders in pregnancy.
- To highlight the evolving landscape of pregnancy complications.
- To emphasize the need for interdisciplinary management and long-term follow-up.
Main Methods:
- Literature review of current understanding of hypertensive pregnancy disorders.
- Analysis of demographic and medical trends affecting pregnancy outcomes.
- Synthesis of evidence on long-term risks for mothers and offspring.
Main Results:
- Hypertensive disorders, including preeclampsia, are projected to increase due to societal and medical changes.
- Women with hypertensive disorders and their offspring face elevated risks of future cardiovascular and metabolic diseases.
- An interdisciplinary approach is essential for managing these complex pregnancies and postpartum care.
Conclusions:
- Effective recognition, classification, and management of hypertensive pregnancy disorders can significantly decrease perinatal mortality and morbidity.
- Understanding pregnancy course is vital for obstetricians and general practitioners.
- Proactive management reduces immediate risks and mitigates long-term health complications for mother and child.
Purpose Of Review:
Hypertension in pregnancy contributes substantially to perinatal mortality and morbidity of both the mother and her child. High blood pressure is mainly responsible for this adverse outcome, in particular when associated with preeclampsia. Although preeclampsia is nowadays a well-known clinical-obstetrical entity, and screening for this complication has been part of routine care during pregnancy for nearly 100 years, its cause is still enigmatic.
Recent Findings:
Profound changes of the demographic development of our society, the worldwide rising prevalence of obesity and metabolic disorders, and progress in reproductive medicine will inevitably modify the prevalence of many medical problems in pregnancy. Complications such as gestational diabetes mellitus, chronic hypertension, and preeclampsia will rise and an interdisciplinary approach is necessary to handle these women during pregnancy and also after delivery. Indeed, it is now well established that these women and their offspring born large or small-for-gestational age are at increased risk for severe cardiovascular and metabolic complications later in life.
Summary:
Knowledge of the pregnancy course is not only important for an obstetrician but also increasingly inevitable for the general practitioner. Recognition, classification, and adequate management of hypertensive pregnancy disorders and associated complications may considerably reduce perinatal death and morbidity.
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