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Hypertensive Disorders of Pregnancy.
Lawrence Leeman1, Lee T Dresang2, Patricia Fontaine3
1University of New Mexico School of Medicine, Albuquerque, NM, USA.
American Family Physician
|March 2, 2016
Summary
Hypertension in pregnancy, including preeclampsia, requires careful management. Prompt diagnosis and treatment of preeclampsia with severe features are crucial for maternal and fetal well-being.
Area of Science:
- Obstetrics and Gynecology
- Maternal-Fetal Medicine
- Cardiology
Background:
- Elevated blood pressure in pregnancy encompasses chronic hypertension, gestational hypertension, preeclampsia, and superimposed preeclampsia.
- Preeclampsia is characterized by hypertension with proteinuria or thrombocytopenia, renal insufficiency, liver dysfunction, pulmonary edema, or neurological symptoms.
Purpose of the Study:
- To outline diagnostic criteria for hypertensive disorders in pregnancy.
- To differentiate between preeclampsia with and without severe features.
- To guide management strategies based on disease severity.
Main Methods:
- Review of diagnostic criteria for hypertensive disorders in pregnancy.
- Classification of preeclampsia based on the presence of severe features.
- Outline of management protocols for preeclampsia with and without severe features.
Main Results:
- Preeclampsia diagnosis requires hypertension and specific organ involvement; proteinuria is not essential.
- Severe features include specific blood pressure thresholds, low platelet counts, elevated liver enzymes, renal insufficiency, and neurological or visual disturbances.
- Management varies from outpatient monitoring to inpatient stabilization and delivery.
Conclusions:
- Accurate diagnosis and classification of hypertensive disorders in pregnancy are vital.
- Management of preeclampsia must be tailored to the presence of severe features.
- Postpartum monitoring is essential for women with hypertensive disorders.
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