Skip to main content

Hypertensive Disorders in Pregnancy

  • Chapter
  • First Online:
Hypertension and Cardiovascular Disease in Asia

Abstract

Hypertension in pregnancy is empirically diagnosed when there is sustained systolic (SBP) of ≥140 mmHg, or a sustained diastolic blood pressure (DBP) ≥ 90 mmHg obtained through a standardized technique of measurement using auscultatory (mercury or aneroid devices) or automated methods. An elevated measurement whether systolic or diastolic must be confirmed on repeat measurement before the woman can be considered hypertensive to reduce the potential for misdiagnosis based on spurious reading or the patient’s anxiousness during the measurement.

It has been observed that low to middle income countries (LMICs) bear a disproportionate burden of maternal morbidity and mortality from the various hypertensive disorders of pregnancy. The provision of good quality antenatal care during the first 4 months of pregnancy based on WHO recommendations is an effective intervention that can reduce maternal and neonatal mortality and morbidity from hypertensive disorders of pregnancy.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 129.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 179.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Steegers EA, von Dadelszen P, Duvekot JJ, Pijnenborg R. Pre-eclampsia. Lancet. 2010;376:631–44.

    Article  Google Scholar 

  2. National Epidemiology Center, Department of Health. The 2013 Philippine health statistics. 2013. http://www.dohgovph/sites/default/files/publications.

  3. Khan KS, Wojdyla D, Say L, Gulmezoglu AM, Van Look PF. WHO analysis of causes of maternal death: a systematic review. Lancet. 2006;367:1066–74.

    Article  Google Scholar 

  4. American College of Obstetricians and Gynecologists. Executive summary: hypertension in pregnancy. Obstet Gynecol. 2013;122:1122–31.

    Article  Google Scholar 

  5. Brown MA, Magee LA, Kenny LC, et al. The hypertensive disorders of pregnancy: ISSHP classification, diagnosis and management recommendations for international practice. Pregnancy Hypertens. 2018;13:291–310.

    Article  CAS  Google Scholar 

  6. Bramham K, Parnell B, Nelson-Piercy C, Seed PT, Postol L, Chappell LC. Chronic hypertension and pregnancy outcomes: systematic review and meta-analysis. BMJ. 2014;348:g2301.

    Article  Google Scholar 

  7. Chappell LC, Enye S, Seed P, Briley AL, Poston L, Shennan AH. Adverse perinatal outcomes and risk factors for preeclampsia in women with chronic hypertension: a prospective study. Hypertension. 2008;51:1002–9.

    Article  CAS  Google Scholar 

  8. Lee ES, Oh MJ, Jung JW, et al. The levels of circulating vascular endothelial growth factor and soluble FLT-1 in pregnancies complicated by preeclampsia. J Korean Med Sci. 2007;22:94–8. PubMed: 17297258.

    Article  CAS  Google Scholar 

  9. Immunology of preeclampsia; current views and hypothesis. In: Kurpisz M.; Fernandez, N., editors Immunology of human reproduction. Sargent, I.L and Smarason, A.K. BIOS Scientific Publishers; Oxford:, 1995, pp. 355–370.

    Google Scholar 

  10. Clinical practice guidelines on hypertension in pregnancy. Philippine Obstetrical, and Gynecological Society; 2015.

    Google Scholar 

  11. Alexander JM, McIntire DD, Leveno KJ, et al. Magnesium sulfate for the prevention of preeclampsia in women with mild hypertension. Am J Obstet Gynecol. 2006;108:826.

    Article  Google Scholar 

  12. Report of the National High Blood Pressure Education Program Working Group on High Blood Pressure in Pregnancy. Am J Obstet Gynecol. 2000;183:S1–22.

    Google Scholar 

  13. Kuo VS, Koumantakis G, Gallery ED. Proteinuria and its assessment in normal and hypertensive pregnancy. Am J Obstet Gynecol. 1992;167:723–8.

    Article  CAS  Google Scholar 

  14. Morris RK, Riley RD, Doug M, Deeks JJ, Kilby MD. Diagnostic accuracy of spot urinary protein and albumin to creatinine ratios for detection of significant proteinuria or adverse pregnancy outcome in patients with suspected pre-eclampsia: systematic review and meta-analysis. BMJ. 2012;345:e4342.

    Article  CAS  Google Scholar 

  15. Phelan LK, Brown MA, Davis GK, Mangos G. A prospective study of the impact of automated dipstick urinalysis on the diagnosis of preeclampsia. Hypertens Pregnancy. 2004;23:135–42.

    Article  CAS  Google Scholar 

  16. North RA, Taylor RS, Schellenberg JC. Evaluation of a definition of preeclampsia. Br J Obstet Gynaecol. 1999;106:767–73.

    Article  CAS  Google Scholar 

  17. Meher S, Duley L, Hunter K, Askie L. Antiplatelet therapy before or after 16 weeks’ gestation for preventing preeclampsia: an individual participant data meta-analysis. Am J Obstet Gynecol. 2017;216:121.

    Article  CAS  Google Scholar 

  18. LeFevre ML, U.S. Preventive Services Task. Low-dose aspirin use for the prevention of morbidity and mortality from preeclampsia: U.S. Preventive Services Task Force Recommendation Statement. Ann Intern Med. 2014;161:819–26.

    Article  Google Scholar 

  19. Hofmeyr GJ, Lawrie TA, Atallah AN, Duley L, Torloni MR. Calcium supplementation during pregnancy for preventing hypertensive disorders and other related problems. Cochrane Database Syst Rev. 2014;(6):CD001059. https://doi.org/10.1002/14651858.CD001059.pub4.

  20. American College of Obstetricians and Gynecologists. Committee Opinion No. 692: emergent therapy for acute-onset, severe hypertension during pregnancy and the postpartum period. Obstet Gynecol. 2017;129:e90–5.

    Article  Google Scholar 

  21. American College of Obstetricians and Gynecologists. ACOG Practice Bulletin No. 202: gestational hypertension and preeclampsia. Obstet Gynecol. 2019;133:e1–25.

    Google Scholar 

  22. Nij Bivank SW, Duvekot JJ. Nicardipine for the treatment of severe hypertension in pregnancy; a review of the literature. Obstet Gynecol Surv. 2010;65:341.

    Article  Google Scholar 

  23. Brown MA, et al. The hypertensive disorders of pregnancy: ISSHP classification, diagnosis & management recommendations for international practice. Pregnancy Hypertens. 2018;13:291–310.

    Article  CAS  Google Scholar 

  24. SOGC Clinical Practice Guideline. Diagnosis, evaluation, and management of the hypertensive disorders of pregnancy: executive summary. J Obstet Gynaecol Can. 2014;36(5):416–38.

    Article  Google Scholar 

  25. Behrens I, Basit S, Melbye M, Lykke JA, Wolfhart J, Bundgaard H, et al. Risk of post-pregnancy hypertension in women with a history of hypertensive disorders of pregnancy: nationwide cohort study. BMJ. 2017;358:3078.

    Article  Google Scholar 

  26. Brown MC, Best KE, Pearce MS, Waugh J, Robson SC, Bell R. Cardiovascular disease risk in women with preeclampsia: systematic review and meta-analysis. Eur J Epidemiol. 2013;281:1–19.

    Article  Google Scholar 

  27. Powe CE, Levine RJ, Karumachi SA. Preeclampsia, a disease of maternal endothelium: the role of antiangiogenic factors and implications for later cardiovascular disease. Circulation. 2011;123:2856–69.

    Article  Google Scholar 

  28. Magee L, von Dadelszen P, Stones W, Mathai M. Diet, lifestyle and place of care. In:The FIGO Textbook of Pregnancy Hypertension: an evidence-based guide to monitoring, prevention and management. London, 2016. 456 p.

    Google Scholar 

  29. Thangaratinam S, Rogozinska E, Jolly K, Glinkowski S, Roseboom T, Tomlinson JW, et al. Effects of interventions in pregnancy on maternal weight and obstetric outcomes: meta-analysis of randomised evidence. BMJ. 2012;344:e2088.

    Article  CAS  Google Scholar 

  30. Muktabhant B, Lawrie TA, Lumbiganon P, Laopaiboon M. Diet or exercise, or both, for preventing excessive weight gain in pregnancy. Cochrane Database Syst Rev. 2015;6:CD007145.

    Google Scholar 

  31. Sacks FM, Svetkey LP, Vollmer WM, Appel LJ, Bray GA, Harsha D, et al. Effects on blood pressure of reduced dietary sodium and the Dietary Approaches to Stop Hypertension (DASH) Diet. N Engl J Med. 2001;344(1):3–10.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Deborah Ignacia D. Ona .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2022 The Author(s), under exclusive license to Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Santos, M.I., Madrigal-Dy, C., Ona, D.I.D. (2022). Hypertensive Disorders in Pregnancy. In: Ram, C.V.S., Teo, B.W.J., Wander, G.S. (eds) Hypertension and Cardiovascular Disease in Asia. Updates in Hypertension and Cardiovascular Protection. Springer, Cham. https://doi.org/10.1007/978-3-030-95734-6_18

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-95734-6_18

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-95733-9

  • Online ISBN: 978-3-030-95734-6

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics