title: Pregnancy outcomes of expectant management of stable mild to moderate chronic hypertension as compared with planned delivery.
abstract: OBJECTIVE
  To compare outcomes between elective delivery at 37 weeks of pregnancy and expectant management among pregnant women with mild to moderate chronic hypertension.
  
  
  METHODS
  In a two-center study, 76 women with mild to moderate chronic hypertension were randomly allocated to planned delivery at 37 completed weeks (group A) or expectant management for spontaneous onset of labor or reaching 41 weeks (group B) between April 2012 and October 2013. Differences were compared by t test, χ(2) test, or Fisher exact test. Odds ratios (ORs) with 95% confidence interval (CIs) were determined.
  
  
  RESULTS
  There were no differences in superimposed pre-eclampsia (SPE), severe hypertension, preterm delivery, placental abruption, oligohydramnios, intrauterine growth restriction, or perinatal mortality between the groups. Group B had higher gestational age at delivery (P=0.001) and birth weight (P=0.01), but lower cesarean (OR 3.4; 95% CI, 1.2-10.3; P=0.03) and neonatal care unit admission (OR 5.4; 95% CI, 1.4-21.0; P=0.01) rates. More women with SPE were diagnosed before than after 37 weeks in group B (P=0.01). Overall, patients who developed SPE had more adverse pregnancy outcomes than those who did not.
  
  
  CONCLUSIONS
  Mild to moderate chronic hypertension could be managed expectantly up to 41 weeks if SPE did not develop.
authors: Department of Obstetrics and Gynecology, Qassim University, Burraidah, Saudi Arabia; Department of Obstetrics and Gynecology, Assiut University, Assiut city, Egypt. Electronic address: Hossam_omar@yahoo.com.
authors: Hossam O
authors: HO
authors: Hamed
authors: Department of Obstetrics and Gynecology, Qassim University, Burraidah, Saudi Arabia.
authors: Muneera A
authors: MA
authors: Alsheeha
authors: Department of Obstetrics and Gynecology, Assiut University, Assiut city, Egypt.
authors: Ahmad M
authors: AM
authors: Abu-Elhasan
authors: Department of Medicine, Qassim University, Burraidah, Saudi Arabia; Department of Medicine, Assiut University, Assiut City, Egypt.
authors: Alaa E
authors: AE
authors: Abd Elmoniem
authors: Department of Physiology, Qassim University, Burraidah, Saudi Arabia; Department of Physiology, Assiut University, Assiut City, Egypt.
authors: Manal M
authors: MM
authors: Kamal
mesh_terms: D000328:Adult; D036861:Delivery, Obstetric; D005260:Female; D006801:Humans; D046110:Hypertension, Pregnancy-Induced; D011247:Pregnancy; D011256:Pregnancy Outcome; D057832:Watchful Waiting; D055815:Young Adult
keywords: Chronic hypertension; Expectant management; Planned delivery; Pregnancy outcomes