A Review of Hypertensive Disorders Management During Pregnancy

Hypertensive disorders are the second direct cause of maternal death affecting ۵ – ۱۰ % of pregnancies. These disorders are associated with increased risk of intracerebral hemorrhage, placental abruption, intrauterine growth retardation, prematurity, and intrauterine death. Chronic hypertension, gestational hypertension, pre-eclampsia, eclampsia, chronic hypertension with superimposed pre-eclampsia are hypertensive disorders in pregnancy. Hypertension control measurement for these conditions includes complete blood count (CBC), serum creatinine (SCr), liver enzymes and ۲۴-h urine protein. Ultrasonographic evaluation of fetus and nonstress test also should be considered. Oral pharmacologic interventions for chronic hypertensin during pregnancy includes Methyldopa, Labetalol and Nifedipine. The use of Angiotensin-Converting Enzyme Inhibitors (ACE-I) and Angiotensin-II Receptor Antagonists could not be used due to teratogenicity. Pre-eclampsia is a disorder which worsens when the pregnancy continues, so the definitive treatment of pre-eclampsia is delivery. The indication for delivery in women with gestational hypertension or pre-eclampsia includes gestational age ≥ ۲۷ weeks, uncontrollable hypertension, persistent neurological symptoms or eclampsia, deteriorating liver and renal function, placental abruption, acute pulmonary edema, persistent epigastric pain with nausea or vomiting with abnormal liver function tests and severe FGR. Hypertensive disorders in pregnancy could increase the risk fetal and maternal mortality. Therefore, early detection and proper management of hypertension needs to be done in pregnant women.  

کلیدواژه ها:

Hypertensive ، Disorders ، Pregnancy.