title: Hypertensive disease of pregnancy and maternal mortality.
abstract: OBJECTIVE
  The incidence of hypertensive disorders in pregnancy is increasing and is associated with maternal mortality worldwide. This review provides the obstetrician with an update of the current issues concerning hypertension and maternal mortality.
  
  
  RESULTS
  Preeclampsia affects about 3% of pregnancies, and all other hypertensive disorders complicate approximately 5-10% of pregnancies in the United States. In industrialized countries, rates of preeclampsia, gestational hypertension, and chronic hypertension have increased as rates of eclampsia have decreased following widespread antenatal care and magnesium sulfate use. Increased maternal mortality is associated with eclampsia, hemolysis, elevated liver enzymes, and low platelet count syndrome, hepatic or central nervous system hemorrhage, and vascular insult to the cardiopulmonary or renal system. Diagnosis and acute management of severe hypertension is central to reducing maternal mortality. African-American women have a higher risk of mortality from hypertensive disorders of pregnancy compared with Hispanic, American Indian/Alaska Native, Asian/Pacific Islander, and Caucasian women.
  
  
  CONCLUSIONS
  Hypertensive disorders in pregnancy are a leading cause of maternal mortality worldwide. The incidence of hypertension in pregnancy continues to increase. Currently, we are unable to determine which patient will develop superimposed preeclampsia or identify subsets of preeclampsia syndrome. Opportunities for research in this area exist to better define treatment aimed at improving maternal outcomes.
authors: Department of Obstetrics and Gynecology, Oregon Health & Science University, Portland, OR 97239, USA. Loj@ohsu.edu
authors: Jamie O
authors: JO
authors: Lo
authors: John F
authors: JF
authors: Mission
authors: Aaron B
authors: AB
authors: Caughey
mesh_terms: D000959:Antihypertensive Agents / Q000627:therapeutic use*; D004461:Eclampsia / Q000175:diagnosis / Q000188:drug therapy / Q000401:mortality*; D005260:Female; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000175:diagnosis / Q000188:drug therapy / Q000401:mortality*; D015994:Incidence; D008278:Magnesium Sulfate / Q000627:therapeutic use*; D008428:Maternal Mortality; D011225:Pre-Eclampsia / Q000188:drug therapy / Q000208:ethnology / Q000401:mortality*; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000175:diagnosis / Q000188:drug therapy / Q000401:mortality*; D011295:Prenatal Care; D012307:Risk Factors; D015149:Tocolytic Agents / Q000627:therapeutic use; D014481:United States / Q000453:epidemiology
chemical_list: D000959:Antihypertensive Agents; D015149:Tocolytic Agents; D008278:Magnesium Sulfate