Hypertensive Conditions: Hypertensive Disorders in Pregnancy

FP Essent. 2022 Nov:522:25-33.

Abstract

Hypertensive disorders in pregnancy (HDP) represent a spectrum of disease that affect women through pregnancy and the immediate postpartum period. These conditions are associated with significant morbidity and mortality during and after pregnancy and have been linked to cardiovascular disease later in life. The HDP spectrum includes gestational hypertension (HTN), preeclampsia, eclampsia, HELLP (hemolysis, elevated liver enzymes, and low platelet count) syndrome, chronic HTN, and chronic HTN with superimposed preeclampsia. Low-dose aspirin is recommended as a preventive drug after 12 weeks' gestation in women who are at high risk of preeclampsia. In HDP, close blood pressure (BP) monitoring, laboratory evaluation, and fetal assessment are warranted. Labetalol and nifedipine extended release are first-line oral antihypertensives for outpatient BP management of chronic HTN; labetalol, hydralazine, and nifedipine immediate release are used for hospitalized patients. HDP may develop or progress in the postpartum period; continued vigilance is important in the puerperium.

MeSH terms

  • Antihypertensive Agents / therapeutic use
  • Female
  • Humans
  • Hypertension, Pregnancy-Induced* / diagnosis
  • Hypertension, Pregnancy-Induced* / drug therapy
  • Labetalol* / therapeutic use
  • Nifedipine / therapeutic use
  • Pre-Eclampsia* / drug therapy
  • Pre-Eclampsia* / prevention & control
  • Pregnancy

Substances

  • Labetalol
  • Nifedipine
  • Antihypertensive Agents