title: Intensification of fetal and maternal surveillance in pregnant women with hypertensive disorders.
abstract: OBJECTIVE
  To examine the need to intensify fetal and maternal surveillance in pregnant women with mild pregnancy hypertension.
  
  
  METHODS
  The multi-center cohort study in 2413 healthy nulliparae analyzed differences in hypertension-related adverse events (small-for-gestational age, perinatal mortality, eclampsia, abruptio placentae and HELLP syndrome) according to maximum diastolic blood pressure and proteinuria.
  
  
  RESULTS
  Compared to the reference group (diastolic blood pressure 70-85 mmHg) (n = 1882) the relative risks of adverse fetal and maternal outcome in 34 proteinuric hypertensive women were 8.9 (95% CI 3.3-24.1) and 41.5 (95% CI 9.7-178.4), respectively. In 203 non-proteinuric women with a maximum diastolic blood pressure of > or = 95 mmHg only the relative risk of adverse maternal outcome was increased (11.6, 95% CI 3.1-42.8), but it was not increased in 230 non-proteinuric women with a maximum diastolic of 90 mmHg.
  
  
  CONCLUSIONS
  Intensified surveillance in women with mild pregnancy hypertension is not indicated and should be reserved for groups with increased fetal and maternal risk.
authors.affiliation: Department of Obstetrics and Gynecology, Academic Medical Center, University of Amsterdam, The Netherlands.
authors.forename: M
authors.initials: M
authors.lastname: Knuist
authors.forename: G J
authors.initials: GJ
authors.lastname: Bonsel
authors.forename: H A
authors.initials: HA
authors.lastname: Zondervan
authors.forename: P E
authors.initials: PE
authors.lastname: Treffers
mesh_terms: D005260:Female; D006801:Humans; D006973:Hypertension; D008880:Midwifery; D009426:Netherlands; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular; D011256:Pregnancy Outcome; D011446:Prospective Studies; D011507:Proteinuria / Q000150:complications / Q000503:physiopathology