Control of hypertension in pregnancy.
The hypertensive disorders of pregnancy are a leading cause of maternal mortality and morbidity. Complications are not limited to preeclampsia but also complicate both preexisting hypertension and isolated gestational hypertension. Blood pressure (BP) management is important but is only one aspect of management of the hypertensive disorders of pregnancy, which may be caused or exacerbated by underlying uteroplacental mismatch between maternal supply and fetal demand. BP treatment thresholds and goals vary in international guidelines, largely reflecting differences in opinion rather than differences in published data. Because of short-term maternal risks, there is consensus that BP should be treated when sustained at greater than or equal to 160 to 170 mm Hg systolic and/or 110 mm Hg diastolic. There is no consensus regarding management of nonsevere hypertension, and randomized controlled trials involving just over 3000 women have not clarified the relative maternal and perinatal risks and benefits. Although antihypertensive therapy may decrease transient severe maternal hypertension, therapy may also impair fetal growth and perinatal health and outcomes. The CHIPS Trial (Control of Hypertension In Pregnancy Study) is recruiting to answer this question.
Magee
Laura A
LA
BC Women's Hospital and Health Centre and the Child and Family Research Institute, University of British Columbia, 4500 Oak Street, Room D213, Vancouver, BC V6H 3N1, Canada. LMagee@cw.bc.ca
Abalos
Edgardo
E
von Dadelszen
Peter
P
Sibai
Baha
B
Walkinshaw
Stephen A
SA
D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure / Q000502:physiology; D005260:Female; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology*; D011247:Pregnancy; D011256:Pregnancy Outcome; D012306:Risk
D000959:Antihypertensive Agents