How Swedish obstetricians manage hypertensive disorders in pregnancy. A questionnaire study

To study treatment of hypertension in pregnancy in Sweden and compare our results with a similar study published in 1981.

A multiple choice questionnaire was sent to 92 obstetricians throughout Sweden and 88% responded.

Most Swedish obstetricians would treat a woman in the second trimester with blood pressure 140/95 mmHg without antihypertensive medication (83%) in the out-patient clinic (81%). The corresponding figures according to a similar study published in 1981 were 33% and 71% of obstetricians, respectively. Almost all obstetricians (95%) would give antihypertensive treatment if the blood pressure was 170/110 mmHg or more. Betablockers and hydralazine were the most commonly used drugs. Sixteen per cent of obstetricians would use calcium antagonists, drugs not available in the previous study. Treatment with diuretics, methyldopa or diazepam in hypertension was rarely used. Eight per cent of obstetricians would give low-dose aspirin to patients with mild hypertension and 20% to patients with severe hypertension. Fourteen per cent of obstetricians would stop all kind of antihypertensive medication and frequently observe patients with essential hypertension.

Antihypertensive therapy and management of hypertensive disorders of pregnancy show a great disparity among Swedish obstetricians. National strategies might improve the morbidity and mortality associated with hypertensive disorders in pregnancy.