title: Maternal and fetal morbidity following discontinuation of antihypertensive drugs in mild to moderate chronic hypertension: A 4-year observational study.
abstract: OBJECTIVE
  To assess maternal and fetal morbidity in women with mild to moderate chronic hypertension on antihypertensive drug therapy compared to cessation of therapy.
  
  
  METHODS
  This was a prospective observational study included 222 women with mild to moderate chronic hypertension (systolic blood pressure of 140-159mmHg or diastolic blood pressure of 90-109mmHg) who were divided into two groups based on antihypertensive drug intake, treatment group (n=104) who received methyl dopa, and non-treatment group (n=118) who used only low dose aspirin. Patients were followed to assess maternal and fetal outcome.
  
  
  RESULTS
  There were significant differences between the two groups regarding the development of severe hypertension (p<0.001), renal impairment (p<0.001), ECG changes (p<0.001), placental abruption (p<0.05), repeated hospital admissions (p<0.001), preterm delivery (p<0.05) and neonatal ICU admission (p<0.05) with higher occurrence in the non-treatment group. There were no significant differences between the two groups in terms of the development of preeclampsia, hepatic impairment, mode of delivery, venous thromboembolism, small for gestational age, intrauterine fetal demise or neonatal mortality (p>0.05).
  
  
  CONCLUSIONS
  Maternal and fetal morbidity is increased following cessation of antihypertensive drug use in patients with mild to moderate chronic hypertension. Further larger studies are warranted to confirm or refute our findings.
authors.affiliation: Obstetrics and Gynecology Department, Faculty of Medicine, Menoufia University, Menoufia, Egypt. Electronic address: m_rezk9207@yahoo.com.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Rezk
authors.affiliation: Obstetrics and Gynecology Department, Faculty of Medicine, Menoufia University, Menoufia, Egypt.
authors.forename: Hamid
authors.initials: H
authors.lastname: Ellakwa
authors.affiliation: Cardiology Department, Faculty of Medicine, Menoufia University, Menoufia, Egypt.
authors.forename: Awni
authors.initials: A
authors.lastname: Gamal
authors.affiliation: Internal Medicine Department, Faculty of Medicine, Menoufia University, Menoufia, Egypt.
authors.forename: Mahmoud
authors.initials: M
authors.lastname: Emara
mesh_terms: D000037:Abruptio Placentae / Q000453:epidemiology; D000328:Adult; D000959:Antihypertensive Agents / Q000008:administration & dosage*; D001794:Blood Pressure; D002908:Chronic Disease; D004562:Electrocardiography; D005260:Female; D005865:Gestational Age; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000503:physiopathology; D015931:Intensive Care, Neonatal; D010359:Patient Readmission; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000188:drug therapy* / Q000503:physiopathology; D047928:Premature Birth / Q000453:epidemiology; D011446:Prospective Studies; D051437:Renal Insufficiency / Q000453:epidemiology; D012720:Severity of Illness Index; D028761:Withholding Treatment
chemical_list: D000959:Antihypertensive Agents
keywords: Chronic hypertension; Fetal outcome; Maternal morbidity