Hypertensive Disorders of Pregnancy

Pregnancy may induce hypertension in previously normotensive women or aggravate hypertension in women who are already hypertensive. The triad of complications of hemorrhage hypertension and sepsis is responsible for the majority of maternal deaths. Good prenatal supervision with the detection of signs and symptoms of incipient preeclampsia can avert maternal-infant morbidity and mortality. Diagnosis of preeclampsia-eclampsia is made on the basis of the development of hypertension with proteinuria or edema or both after 20 weeks of pregnancy. These conditions occur most often in the 1st pregnancy. Women with antecedent hypertension frequently react to pregnancy with preeclampsia superimposed on the underlying chronic disorder. The incidence of preeclampsia is about 5%. pregnancy-induced or aggravated hypertension is most likely to develop in women who are exposed to chorionic villi for the 1st time are exposed to a superabundance of chorionic villi and covering trophoblast as with twins have preexisting vascular disease and are genetically predisposed to the development of hypertension during pregnancy. A rapid weight gain during the last half of pregnancy or an upward trend in the diastolic blood pressure are danger signals. The only specific treatment of preeclampsia is termination of the pregnancy. The basic treatment of eclampsia consists of control of convulsions and steps to effect delivery. Hypertension has been reported in as many as 78% of women who previously had eclampsia.