Skip to Main Content

++

INTRODUCTION

++

Prevalence and Relevance

++

Hypertension is the most frequent reason for office visits in the general population,1 as well as the most common medical condition complicating up to 10% of pregnancies.2,3,4,5 The incidence of hypertension has increased significantly over the last 10 years, with an estimate of 40% to 50% rise,5,6 and therefore, the above figures may be understated. This goes hand in hand with an increase in obesity rates in the United States, which may subsequently lead to higher incidence of diabetes mellitus.6,7 Other possible reasons for the increase in hypertension in pregnancy include the increased rate of multiple gestation secondary to assisted reproductive technology and increase in the age of pregnant women because of delay in having children.

++

Hypertension is the second most common cause of maternal death in the United States8 and African American women have a fourfold increase in mortality rate.9 The mortality rate is also increased in women over the age of 35 years.10

++

Table 12-1 summarizes the potential adverse effects and maternal and fetal complications of hypertension.

++
Table Graphic Jump Location
TABLE 12-1Adverse Outcomes in Severe Hypertensive Disorders of Pregnancy
++

Hypertension in Pregnancy Task Force Report

++

The Task Force on hypertension in pregnancy comprised 17 clinician-scientists from the fields of obstetrics, maternal-fetal medicine, hypertension, internal medicine, nephrology, anesthesiology, physiology, and patient advocacy. These experts in the management of hypertension in pregnancy reviewed available data and provided evidence-based recommendations for clinical practice.

++

Its main contribution was in making evidence-based recommendations to modernize the definition and management of preeclampsia. Proteinuria was eliminated as a required criterion for diagnosis. In addition, preeclampsia is no longer classified as mild versus severe, but rather by having evidence of hypertensive pathology, and its severe form as defined by having severe features.

++

Management algorithms were provided accordingly for hypertensive disorders in pregnancy with and without severe features. Many of their management recommendations, particularly those for disease with severe features, provide much-needed clarity.

++

DEFINITIONS AND CLASSIFICATIONS

++

Hypertension is defined as a systolic blood pressure (BP) ≥140 mmHg or a diastolic BP ≥90 mmHg. These measurements must be made on at least two occasions, no less than 4 hours and no more than a week apart, unless severe BP ranges are ...

Want remote access to your institution's subscription?

Sign in to your MyAccess profile while you are actively authenticated on this site via your institution (you will be able to verify this by looking at the top right corner of the screen - if you see your institution's name, you are authenticated). Once logged in to your MyAccess profile, you will be able to access your institution's subscription for 90 days from any location. You must be logged in while authenticated at least once every 90 days to maintain this remote access.

Ok

About MyAccess

If your institution subscribes to this resource, and you don't have a MyAccess profile, please contact your library's reference desk for information on how to gain access to this resource from off-campus.

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.