Hypertension in pregnancy. Outcomes, proteinuric vs. nonproteinuric

To study perinatal and maternal outcome in pregnancies with proteinuric and nonproteinuric hypertension and, on the basis of our observations, to formulate guidelines for management of women with non-proteinuric hypertension.

Review of charts of 216 women with hypertensive disorders of pregnancy over a period of 18 months was carried out. Statistical analysis was performed using the chi 2 test.

Nonproteinuric hypertension generally occurred after 37 weeks of gestation, and in 64% of cases the diastolic blood pressure remained < 100 mm Hg. Only 15% required antihypertensives, and perinatal mortality and small-for-dates infants were significantly less common when compared to those in the proteinuric group.

Proteinuria should be considered an important marker of perinatal outcome. Women with nonproteinuric hypertension may be managed in the outpatient clinic. Monitoring by serial ultrasound scan and cardiotocography is required only in selected cases.