Treatment of severe hypertension during pregnancy: we still do not know what the best option is

Hypertens Pregnancy. 2020 Feb;39(1):25-32. doi: 10.1080/10641955.2019.1708383. Epub 2019 Dec 27.

Abstract

Intracranial hemorrhage and stroke are primary causes of maternal mortality in pregnancies affected by hypertensive disorders. As such antihypertensive therapy plays a crucial role in the management of severe hypertension. However, the target level to achieve the best outcome for both - mother and fetus - is still unclear. Moreover, given the lack of well-designed randomized controlled trials with standardized key outcomes, the current choice of antihypertensive medications depends rather on clinicians' preference. Furthermore, data on long-term outcomes of offspring is not available. Therefore, there is an urgent need for randomized trials comparing different anti-hypertensive options to address efficacy and safety questions.

Keywords: Severe hypertension in pregnancy; key outcome parameters; maternal and perinatal morbidity; pre-eclampsia; target blood pressure.

Publication types

  • Review

MeSH terms

  • Antihypertensive Agents / therapeutic use*
  • Dose-Response Relationship, Drug
  • Drug Administration Schedule
  • Female
  • Humans
  • Hypertension, Pregnancy-Induced / drug therapy*
  • Intracranial Hemorrhage, Hypertensive / etiology
  • Intracranial Hemorrhage, Hypertensive / prevention & control
  • Pregnancy
  • Severity of Illness Index
  • Stroke / etiology
  • Stroke / prevention & control
  • Treatment Outcome

Substances

  • Antihypertensive Agents