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Chronic hypertension in pregnancy

W C Mabie, M L Pernoll, M K Biswas

    Obstetrics and Gynecology
    |February 1, 1986
    PubMed

    Insights

    Managing chronic hypertension in pregnancy requires more than just blood pressure control. Key factors include accurate dating, addressing medical issues, fetal monitoring, and timely delivery for optimal outcomes.

    Area of Science:

    • Obstetrics and Gynecology
    • Cardiology
    • Perinatology

    Background:

    • Chronic hypertension affects 169 pregnancies in 156 women.
    • Antihypertensive medication initiated if diastolic blood pressure > 90 mmHg.
    • Associated medical conditions identified as significant factors.

    Purpose of the Study:

    • To investigate the course and outcomes of pregnancies complicated by chronic hypertension.
    • To identify high-risk indicators and assess the impact of antihypertensive therapy.

    Main Methods:

    • Retrospective study of 169 pregnancies in women with chronic hypertension.
    • Monitoring of blood pressure, associated medical conditions, and pregnancy outcomes.
    • Analysis of perinatal mortality, superimposed preeclampsia, and fetal growth retardation.

    Main Results:

    • High-risk indicators: left ventricular hypertrophy, serum creatinine > 1.0 mg%, early diastolic pressure > 100 mmHg.
    • Perinatal mortality: 28.4/1000. Superimposed preeclampsia affected one-third of patients.
    • Fetal growth retardation occurred in 15%, with higher incidence (20% vs 5%) in those treated with antihypertensives, particularly methyldopa.

    Conclusions:

    • Controlling blood pressure is crucial but insufficient for managing chronic hypertension in pregnancy.
    • Accurate dating, managing comorbidities, antenatal fetal assessment (ultrasound, heart rate monitoring), and timely delivery are vital.
    • Perinatal outcomes were similar to studies withholding antihypertensive therapy, suggesting a multifactorial approach is essential.

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