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Chronic hypertension in pregnancy.

W C Mabie, M L Pernoll, M K Biswas

    Obstetrics and Gynecology
    |February 1, 1986
    PubMed
    Summary
    This summary is machine-generated.

    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.

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    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.

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    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.