title: PP099. Chronic hypertension: follow-up of chronic hypertension pregnant women in 2008-2009.
abstract: BACKGROUND
  Chronic Hypertension (CH) is one of the most prevalent diseases in the world. Because women are getting pregnant in late ages, the incidence of Chronic Hypertension in pregnancy is raising (2-3%). As a long term disease in its essential form, with low repercussion in target-organs at reproductive age, the medical complications related to CH are not the main concern of the pregnant women. However, it influences the pregnancy and may result in serious maternal-fetal complications, especially if a preeclampsia/eclampsia superimposes to pregnancy. The complications may be manifested as placental abruption, acute renal failure, cardiac decompensation, and cerebral accidents in the mother and of growth restriction and unexplained mid-trimester fetal death. The main goal in the follow-up of this pregnant women is to achieve controlled levels of blood pressure (Systolic - 110-140mmHg, Diastolic - 80-90mmHg) with anti-hypertensive drugs, and evaluate and early diagnose the most serious complication, preeclampsia/eclampsia(PE/E).
  
  
  OBJECTIVE
  Review the cases of Chronic Hypertension followed in our institution in 2008-2009, with the analysis of population, anti-hypertensive drugs required to control HTA, fetal complications (growth restriction, preterm delivery and fetal death) and maternal/fetal complications (PE/E, Abruption placentae, Renal and Cardiac acute insufficiency, and cerebral accidents).
  
  
  METHODS
  In a retrospective study, from January 2008 to December 2009, were analysed all files related with Chronic Hypertension followed in the obstetric department of Prof. Fernando Fonseca's Hospital. The statistic analysis was based on Excel 2007.
  
  
  RESULTS
  The incidence of Chronic Hypertension was 40% of all hypertensive disorders in this period and of 1,5% in overall pregnant population. The maternal mean age of this group was 33,8 years (16;44) being the most prevalent pre-existing co-morbidities the endocrinologic disorders (obesity, Diabetes and thyroid pathology). 38% were previous medicated with anti-hypertensive drugs, the majority of them needing only one drug to control blood pressure (BP) (64%). During the pregnancy follow up, 78% were medicated with one or more anti-hypertensive drugs, requiring only one drug to control BP in the majority of cases 66%. In terms of fetal complications 3 cases of growth restriction were signed (2%), preterm delivery in 26 cases (21%) and 2 interruptions of pregnancy in the second trimester before 24 weeks because of maternal complications (2%). There was one case of Abruption Placentae (1%). In terms of maternal complications there were 5 ICU internments (4%), and one situation of acute cardiac disfunction (1%). The CH was complicated by PE/E in 22 cases (18%).
  
  
  CONCLUSIONS
  Chronic Hypertension is a prevalent disease, with an elevated incidence in pregnancy, and potential major fetal-maternal complications, obliging medical professionals to a straight and careful follow-up to control BP levels and early diagnose the adversely outcomes.
authors.affiliation: Obstetrics and Gynecology, Hospital Fernando Fonseca, Lisbon, Portugal.
authors.forename: A F
authors.initials: AF
authors.lastname: Caeiro
authors.affiliation: Obstetrics and Gynecology, Hospital Fernando Fonseca, Lisbon, Portugal.
authors.forename: V
authors.initials: V
authors.lastname: Santos
authors.affiliation: Obstetrics and Gynecology, Hospital Fernando Fonseca, Lisbon, Portugal.
authors.forename: G
authors.initials: G
authors.lastname: Dias
authors.affiliation: Obstetrics and Gynecology, Hospital Fernando Fonseca, Lisbon, Portugal.
authors.forename: E
authors.initials: E
authors.lastname: Landim
authors.affiliation: Obstetrics and Gynecology, Hospital Fernando Fonseca, Lisbon, Portugal.
authors.forename: I
authors.initials: I
authors.lastname: Santos
authors.affiliation: Obstetrics and Gynecology, Hospital Fernando Fonseca, Lisbon, Portugal.
authors.forename: T
authors.initials: T
authors.lastname: Matos
authors.affiliation: Obstetrics and Gynecology, Hospital Fernando Fonseca, Lisbon, Portugal.
authors.forename: A
authors.initials: A
authors.lastname: Nazaré