Hypertensive Disorders in Pregnancy Current Practice Review

Hypertensive disorders (preeclampsia, eclampsia, gestational hypertension, and chronic hypertension with superimposed preeclampsia) complicate 3-5% of all pregnancies and are a significant cause of maternal mortality and morbidity. Preeclampsia is a multi-system disorder characterised by new onset hypertension after the 20th week of pregnancy with proteinuria. Proteinuria is defined as 300 mg or more of protein in a 24-hour urine collection or a protein: creatinine ratio of 0.3 mg/dL using a spot urine specimen. Hypertensive disorders have a complex pathophysiology that results from abnormal placen- tation and a maternal response that develops into a clinicalsyndrome for which there is no single test or "cure". In high income countries, low rates of maternal mortality from hy- pertensive disease in pregnancy illustrate the importance of pregnant women being able to readily access antenatal care.

There remains the need to develop evidence-based clinical guidelines for detection, prophylaxis and management worldwide.