The management of hypertension in pregnancy.
Hypertension in pregnancy probably has many causes. Increasing blood pressure carries an increasing risk to mother and fetus, particularly when associated with proteinuria and hyperuricaemia. Insufficient attention has been paid to a normal fall in diastolic blood pressure during early and mid-pregnancy; hence standards of normality need to be set. Antihypertensive treatment may reduce perinatal mortality and improve fetal and placental growth. Alpha- and beta-adrenergic blockers may be better than alpha-methyldopa. Pregnancy should be terminated as soon as risk from hypertension is greater than risk of fetal prematurity. Successful management depends upon a careful clinical, biochemical, and biophysical assessment of maternal and fetal condition and fetal maturity. Examination of amniotic fluid for surfactant, the use of dexamethasone to accelerate pulmonary maturity, and intravaginal PGE2 for cervical ripening and induction of labour are significant advances. With critical observation, timely intervention and sympathetic care a successful and happy outcome can be achieved in most pregnancies.
D000032:Abortion, Therapeutic; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure; D005260:Female; D006801:Humans; D006973:Hypertension / Q000628:therapy*; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000628:therapy*
D000959:Antihypertensive Agents