scholarly journals A survey on the measurement of blood pressure in pregnant women and management of hypertensive disorders of pregnancy by the Japan Society for the Study of Hypertension in Pregnancy (JSSHP)

Author(s):  
Hirotada Suzuki ◽  
Kenjiro Takagi ◽  
Kanji Tanaka ◽  
Atsuhiro Ichihara ◽  
Hiroyuki Seki
2017 ◽  
Author(s):  
Kavitha Vellanki ◽  
Susan Hou

Hypertensive disorders are the second leading cause of maternal mortality in the United States. Hypertension in pregnancy is defined as blood pressure greater than or equal to 140 mm Hg systolic or greater than or equal to 90 mm Hg diastolic, measured on at least two separate occasions. Preeclampsia, as per the new guidelines, is characterized by the new onset of hypertension and either proteinuria or other end-organ dysfunction, more often after 20 weeks of gestation in a previously normotensive pregnant woman. New-onset proteinuria is not required for diagnosis of preeclampsia if there is evidence of other end-organ damage—a change from previous classifications. Although no screening test has yet proven accurate enough to predict preeclampsia, the use of a combination of the serologic factors seems promising. There are few data to support any specific blood pressure target in pregnancy. Although there is a general consensus on treating severe hypertension in pregnancy, there is a difference of opinion on treating mild to moderate hypertension in pregnancy. Avoiding uteroplacental ischemia and minimizing fetal exposure to adverse effects of medications are as important as avoiding maternal complications from high blood pressure during pregnancy. This review contains 2 figures, 4 tables, and 73 references.


ESC CardioMed ◽  
2018 ◽  
pp. 2872-2874
Author(s):  
Renata Cifkova

Hypertensive disorders in pregnancy are the most common medical complications affecting 5–10% of pregnancies worldwide. This chapter discusses the following topics: diagnosis of hypertension, definition and classification of hypertension in pregnancy, additional laboratory tests, management of hypertension in pregnancy, pharmacological management of hypertension in pregnancy, delivery induction, blood pressure postpartum and lactation, and prognosis after pregnancy.


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.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Amyna Helou ◽  
Kay Stewart ◽  
Kath Ryan ◽  
Johnson George

Abstract Background Hypertensive disorders are a leading cause of mortality and morbidity during pregnancy. Despite multiple national and international clinical guidelines and a plethora of research in the field of optimising management, there has been limited research describing the perspectives and experiences of pregnant women with the management of hypertensive disorders of pregnancy (HDP). Understanding these perceptions and experiences is imperative to the optimisation of HDP management. Methods A qualitative study involving face-to-face, in-depth interviews were undertaken with 27 pregnant women diagnosed with and being treated for HDP to explore their perspectives of and experiences with clinical management. Written consent was obtained individually from each participant, and the interviews ranged from 16 to 54 min. Inductive codes were generated systematically for the entire data set. Line-by-line analysis was then performed and nodes were created within NVivo, a qualitative data management software. Data collection was continued until thematic saturation was reached. Thematic analysis was employed to interpret the data. Results Three major descriptive themes were discerned regarding the women’s perspectives on and experiences with the management of HDP: attitudes towards monitoring of HDP, attitudes and perceptions towards development and management of complications, and perceptions of pregnant women with chronic hypertension. Trust in the hospital system, positive attitudes towards close blood pressure monitoring as well as self-monitoring of blood pressure, and a realistic approach to emergency antenatal hospital admissions contributed to a positive attitude towards monitoring of HDP. Women with prior experiences of HDP complications, including pre-eclampsia, were more confident in their clinical management and knew what to expect. Those without prior experience were often in shock when they developed pre-eclampsia. Some women with chronic hypertension displayed limited understanding of the potential risks that they may experience during pregnancy and thus lacked comprehension of the seriousness of the condition. Conclusions The clinical management experiences of pregnant women with HDP were varied. Many women did not feel that they were well informed of management decisions and had a desire to be more informed and involved in decision-making. Clear, concise information about various facets of HDP management including blood pressure monitoring, prescription of the appropriate antihypertensive agent, and planning for potential early delivery are required.


2021 ◽  
Vol 14 (4) ◽  
pp. 642-650
Author(s):  
Syamraini Silda ◽  
Ana Mariza ◽  
Sunarsih Sunarsih

Factors for hypertensive disorders of pregnancy among mothers in Lampung, IndonesiaBackground: Hypertension in pregnancy when blood pressure reaching 140/90 mmHg or more, which occurs during pregnancy. Hypertension in pregnancy can cause mortality and the number of prevalent still too high.Purpose: To know the factors associated with hypertension among pregnant women Inpatient public health centre, South Lampung.Method: A quantitative study with a cross-sectional with a prospective approach. The sampling was all pregnant women who follow up at the health center of 80 respondent on May 20 - July 24, 2019 taken by accidental sampling and data collected using observational sheets and interviews. Data analysis using chi-square test to find correlation among variables.Results: Shows that of 80 respondents who suffering of hypertension of 45%, age its risky category of  57.5%, parity its risky category, has obesity of 42.5% and having a history of hypertension in those without a previous history of hypertension of 35%. Statistical test results show that age its risk with p = 0.029, parity its risk (p = 0,000), obesity (p = 0.000) and a history of hypertension (p = 0.000). conclusion that there was a relationship between age its risk, parity its risk, obesity, and hypertension history with the incidence of hypertensionKeywords: Hypertensive disorders; Pregnancy; An age of risk; A parity of risk; Obesity; History of hypertensionPendahuluan:Hipertensi dalam kehamilan adalah tekanan darah mencapai 140/90  mmHg atau lebih yang terjadi saat kehamilan. Hipertensi pada kehamilan dapat menyebabkan mortalitas pada ibu hamil dan angkanya masih cukup relatif tinggi.Tujuan: Diketahui faktor-faktor yang berhubungan dengan hipertensi pada ibu hamil di wilayah kerja UPT Puskesmas Rawat Inap Katibung Lampung Selatan.Metode : Penelitian kuantitatif dengan pendekatan desain cross sectional study pendekatan prospektif. Teknik pengambilan sampel yang dilakukan adalah Accidental sampling. Sampel dalam penelitian ini adalah seluruh ibu hamil yang datang ke Puskesmas selama penelitian berlangsung yaitu sebanyak 80 ibu hamil pada tanggal 20 Mei – 24 Juli 2019 . Pengumpulan data diperoleh menggunakan lembar observasional dan wawancara. Analisis hubungan menggunakan uji chi-square.Hasil: Menunjukkan bahwa dari 80 ibu hamil yang mengalami hipertensi sebanyak 36 orang (%) sedangkan yang tidak hipertensi sebanyak 44 orang (%).Umur terbanyak pada yang beresiko 46 orang (57,5%) , Paritas pada yang tidak beresiko sebanyak 43 orang (53,75%) , Obesitas yang terbanyak pada yang tidak obesitas 46 orang (57,5%) dan Riwayat hipertensi sebelumnya terbanyak pada yang tidak ada riwayat hipertensi sebelumnya sebanyak 52 orang (65%).Hasil uji statistik bivariate menunjukkan bahwa umur (p=0,029) , paritas (p=0,000) , obesitas (p=0.000) dan  riwayat hipertensi (p=0.000) sehingga disimpulkan umur, paritas, obesitas dan riwayat hipertensi berhubungan dengan kejadian hipertensi pada ibu hamil.


Author(s):  
Bharti . ◽  
Sumit Chawla

Background: Pregnancy in hypertension may complicate pregnancies with variable incidence among different settings. Pregnancies complicated with hypertensive disorders are associated with increased risk of adverse fetal, neonatal and maternal outcome including preterm birth, intrauterine growth retardation (IUGR), perinatal death etc. The present study was undertaken to study the perinatal outcome of hypertension in pregnancy in a rural block of Haryana.Methods: This cross-sectional study was carried out in the all the 20 subcenters under Community Health Center (CHC) Chiri, Block Lakhanmajra. All the pregnant women registered at the particular subcenter at a point of time of visit were included in the study. Pregnancy outcome was followed-up by contacting the health worker of respective sub-center or mother. Information regarding stillbirth, abortion, maturity, birth weight, mode of delivery and early neonatal death was collected. Appropriate statistical tests were used for analysis.Results: A total of 931 pregnant women were included in the present study. Prevalence of hypertension in pregnancy was found to be 6.9%. Hypertension in pregnancy is significantly associated with premature births still births (6.7% vs 1.4%; p=0.003), low birth weight (26.7% vs 4.9%; p=0.000) and early neonatal deaths (8.3% vs 2.8%; p=0.017).Conclusions: Perinatal mortality is significantly high in mothers with hypertensive disorders. Early diagnosis and treatment through regular antenatal checkup is a key factor to prevent hypertensive disorders of pregnancy and its complications.


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>


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