THE CLASSIFICATION AND DIAGNOSIS OF THE HYPERTENSIVE DISORDERS OF PREGNANCY: STATEMENT FROM THE INTERNATIONAL SOCIETY FOR THE STUDY OF HYPERTENSION IN PREGNANCY (ISSHP)

2001 ◽  
Vol 20 (1) ◽  
pp. ix-xiv ◽  
Author(s):  
Mark A. Brown ◽  
Marshall D. Lindheimer ◽  
Michael de Swiet ◽  
Andre Van Assche ◽  
Jean-Marie Moutquin
2019 ◽  
Vol 2019 ◽  
pp. 1-8 ◽  
Author(s):  
Wendy N. Phoswa

Purpose of the Review. Hypertension in pregnancy is the global health burden. Amongst the hypertensive disorders of pregnancy, preeclampsia and gestational hypertension are the world’s leading disorders that lead to both maternal and fetal morbidity and mortality. Recent Findings. Dopamine inactive metabolites, namely, monoamine oxidase (MAO) and catechol-O-methyl transferase (COMT), have been reported to be associated with hypertensive disorders of pregnancy such preeclampsia and gestational hypertension. Summary. This review discusses the involvement of MAO and COMT in the pathophysiology of both conditions in order to have a better understanding on the pathogenesis of both conditions, suggesting promising therapeutic interventions and subsequently reducing maternal and fetal morbidity and mortality.


2019 ◽  
Vol 7 ◽  
pp. 205031211984370 ◽  
Author(s):  
Stephanie Braunthal ◽  
Andrei Brateanu

Hypertensive disorders of pregnancy, an umbrella term that includes preexisting and gestational hypertension, preeclampsia, and eclampsia, complicate up to 10% of pregnancies and represent a significant cause of maternal and perinatal morbidity and mortality. Despite the differences in guidelines, there appears to be consensus that severe hypertension and non-severe hypertension with evidence of end-organ damage need to be controlled; yet the ideal target ranges below 160/110 mmHg remain a source of debate. This review outlines the definition, pathophysiology, goals of therapy, and treatment agents used in hypertensive disorders of pregnancy.


2019 ◽  
Vol 14 (2) ◽  
pp. 102-108 ◽  
Author(s):  
Sabrina Youash ◽  
Verinder Sharma

Background: Hypertensive disorders of pregnancy including gestational hypertension, preeclampsia and eclampsia are conditions that cause significant perinatal and maternal morbidity and mortality. </P><P> Objective: This is a systematic review of the current evidence examining the relationship between both depression and antidepressants on pregnancy-related hypertensive conditions. </P><P> Methods: In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol, six databases were searched for articles published between January 1990 and December 2017 (PubMed, Embase, PsycINFO, Cochrane Database of Systematic Reviews, MEDLINE and ClinicalTrials. gov). Randomized control trials, cohort studies and case-control studies were included in this review. Studies that measured the following exposures were included: Antidepressant exposure or diagnosis of depression. Studies that measured the following outcomes were included: Gestational hypertension, preeclampsia or eclampsia. A combination of keywords, as well as Medical Subject Headings (MeSH) index terms, was used for three general categories: antidepressants, depression and hypertensive disorders of pregnancy. A total of 743 studies were identified and 711 were excluded based on relevance to the research question. Twenty studies were included in the final systematic review. </P><P> Results: Of the twenty relevant studies, ten specifically examined the relationship between depression and hypertension in pregnancy. Only two of these did not find a significant association. Of the ten studies that concentrated on antidepressant medications, all except one found an association with hypertension in pregnancy to varying degrees. </P><P> Conclusion: Review of the literature suggests a possible association between depression and antihypertensive medications with pregnancy-related hypertension, but further studies are needed.</P>


Author(s):  
Prathima A. ◽  
Reddi Rani P.

Background: Hypertensive disorders remain the most common medical complication during pregnancy and contribute greatly to maternal and perinatal morbidity and mortality. Several tests have been proposed to identify the women at risk of developing hypertension. Among the various predictors, the placental location by USG at 18-24 weeks is cost effective, non- invasive and has a good positive predictive value. The present study was undertaken to predict the association of placental location with the development of hypertension in pregnancy.Methods: This was a longitudinal cohort study conducted on 380 uncomplicated primigravid women who attended the obstetric OPD of MGMC&RI over a period of 18 months (March 2017-august 2018). A detailed history was taken, and examination done and B.P. was measured. The placental location was determined by ultrasound at 18-24 weeks and the patients were divided into two groups : group A were women with lateral placenta and group B were women with other placental locations. All women were followed up for signs and symptoms of hypertensive disorders of pregnancy and mode of delivery and neonatal outcome were noted.Results: Out of 380 women, 56(14.7%) had lateral placenta and 324(85.3%) had other placental locations. Out of the 57 women who developed hypertensive disorders in pregnancy, 16(28.6%) had lateral placenta and 41(12.7%) had other placental locations. The risk of developing hypertension in pregnancy with lateral placenta was 3.5(odds ratio) with a 95% confidence interval (1.4-8.6). The sensitivity, specificity, positive predictive value and negative predictive value when placental laterality is used as a predictive test was 28.1%, 87.6%, 28.6% and 87.4% respectively.Conclusions: The placental laterality as determined by ultrasound at 18-24 weeks is a simple, non-invasive, cost-effective predictive test to predict women at high risk of developing hypertensive disorders of pregnancy and this test has a high specificity and negative predictive value.


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