Hypertension in pregnancy: a review of preecamplesia, its effects and management

ABSTRACT

Hypertension complicates 5% to 7% of all pregnancies. Pre-eclampsia is a major contributor to maternal mortality worldwide. In Africa and Asia they contribute to 9% of deaths. A subset of preeclampsia, characterized by new-onset hypertension, proteinuria, and multisystem involvement, is responsible for substantial maternal and fetal morbidity and is a marker for future cardiac and metabolic disease. It is a pregnancy-specific disease characterized by de-nova development of concurrent hypertension and proteinuria, sometimes progressing into a multi organ cluster of varying clinical features. Poor early placentation is especially associated with early onset disease. Symptomatic clinical management should be mainly directed to prevent maternal morbidity [e.g. eclampsia] and mortality. Expectant management of women with early onset disease to improve perinatal outcome should not preclude timely delivery - the only definitive cure