Chronic Hypertension During Pregnancy: Consensus And Controversies
Keywords:
chronic hypertension, pregnancy, high risk pregnancyAbstract
With incidences ranging between 5% and 10% worldwide, pregnancy-associated hypertensive syndromes represent the main cause of maternal mortality in many countries. According to the National High Blood Pressure Education Program Working Group on High Blood Pressure, chronic hypertension is defined as hypertension present before pregnancy, diagnosed before the twentieth week of pregnancy, or diagnosed for the first time during pregnancy and which does not disappear during the postpartum period. There are many complications associated with high blood pressure during pregnancy, both from a maternal and perinatal point of view. From the maternal point of view, hypertensive encephalopathy, heart failure, severe impairment of renal function, retinal hemorrhage, coagulopathies and association with pre-eclampsia may occur. For the fetus, there is a greater risk of intrauterine growth restriction, placental abruption, suffering, intrauterine death, low weight and prematurity. This review addresses aspects relating to both the classification, diagnosis, clinical and laboratory monitoring, and the therapeutic management of chronic arterial hypertension during pregnancy. In addition to these, we also focus on controversial aspects that require better scientific evidence.
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