[Chronic high blood pressure in 110 pregnant women].
BACKGROUND
Hypertension is associated with increased maternal and fetal mortality and morbidity. While there is consensus that severe hypertension should be treated, antihypertensive treatment for mild chronic hypertension during pregnancy remains controversial.


OBJECTIVE
To evaluate clinical course, and maternal and perinatal outcomes of pregnant women with mild chronic hypertension without other disease, under strict control of maternal hypertension (target dBP of 85-89 mmHg).


METHODS
We conducted a prospective cohort study of 110 pregnant women with mild chronic hypertension without other disease; clinical course was classified in three groups: stable condition, exacerbation of hypertension and superimposed preeclampsia. We compare maternal and perinatal outcomes; statistical comparisons were performed by ANOVA test. Relative risk (RR) was calculated for adverse perinatal outcomes.


RESULTS
Atotal of 110 women were included, mean maternal age was 33 +/- 5.8 years. There were 78 (71%) women with stable condition, 26 (24%) with exacerbation of hypertension and 6 (5%) with superimposed preeclampsia (PE). Women with superimposed PE and exacerbation of hypertension delivered earlier and had more small for gestational age (SGA) babies than women with stable condition and exacerbation. Delivery route was vaginal in 45 patients (40%) while 65 patients (60%) underwent cesarean section in order to avoid fetal distress.


CONCLUSIONS
Results demonstrated that fetuses in the stable condition group (strict control) did not have worst outcomes than those in the other groups. This cohort study shows efficacy and safety of treating mild chronic hypertension during pregnancy.
Iñigo Riesgo
Carmen Armida
CA
Unidad Médica de Alta Especialidad, Hospital de Ginecoobstetricia, Centro Médico Nacional de Occidente, IMSS, México. mcairiesgo@hotmail.com
Torres Gómez
Luis Guillermo
LG
Vargas González
Alejandro
A
Angulo Vázquez
José
J
Espinoza Ortegón
María Angélica
MA
D000328:Adult; D005260:Female; D006801:Humans; D006973:Hypertension / Q000628:therapy; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000628:therapy; D011446:Prospective Studies; D055815:Young Adult