The treatment of hypertension in pregnancy

Publication date: Available online 9 January 2017 Source:Anaesthesia & Intensive Care Medicine Author(s): Umbareen Siddiqi, Felicity Plaat Maternal deaths from complications of pregnancy; so-called ‘direct deaths’, including hypertensive disorders, are now less than from indirect causes, (medical conditions that may be exacerbated by pregnancy). The direct death rate in the UK has fallen significantly over the past 5 years. The death rate from hypertensive disorders is at its lowest ever: 0.25/100 × 103 maternities [95%CI 0.09–0.55]. In other words there is one death from hypertensive disorders for every 400,000 maternities. Having been one of the leading direct causes of maternal mortality, it now lags behind thromboembolic disease, haemorrhage and amniotic fluid embolism. This improvement is likely to reflect careful management not a fall in incidence as hypertensive disorders remain one of the commonest complications of pregnancy. The precise trigger for pre-eclampsia has yet to be elucidated but the pathophysiology involves abnormal placentation and an exaggerated inflammatory response causing a multisystem disorder. Raised or rising blood pressure in a pregnant woman should alert the clinician to look for the development of pre-eclampsia. Diagnosis and treatment of hypertensive disorders in pregnancy is vital they are associated with both a worse maternal and fetal outcome. Current recommendations suggest that all pregnant women with a systolic blood p...
Source: Anaesthesia and intensive care medicine - Category: Anesthesiology Source Type: research