The New Hypertensive Guidelines for Pregnancy

CE: Gestational Hypertension, Preeclampsia, and Peripartum Cardiomyopathy: A Clinical Review

“…(Butalia et al, 2018) For diagnostic purposes, blood pressure should be measured in a clinical setting twice with at least four hours between measurements, using the arm with the highest values. (Butalia et al, 2018;Pfaff, 2014) Although most women with gestational hypertension will not suffer any complications,(American College of Obstetrics and Gynecologists, 2019) the condition has been associated with higher risk for developing diabetes and kidney disease in later life. (Kintiraki et al, 2015) Gestational hypertension severity is a predictor of worse outcomes.…”

“…(Melamed et al, 2014) Preeclampsia can be diagnosed after 20 weeks of gestation when there is new-onset hypertension with either proteinuria or indications of target organ dysfunction, including pulmonary edema; cerebrovascular disturbances (including visual disturbances like flashing lights, blurred vision); or signs of kidney failure (such as low urine output, electrolyte imbalance). Proteinuria is diagnosed when the protein-to-creatinine ratio of two urine samples taken at least six hours apart exceeds 0.3 mg/dL(American College of Obstetricians and Gynecologists, 2013;Pfaff, 2014) or when the protein concentration of a 24-hour urine excretion sample equals or exceeds 300 mg(American College of Obstetricians and Gynecologists, 2013;Butalia et al, 2018). If not managed, preeclampsia can progress to eclampsia, as defined by the onset of seizures.…”

“…Noticing the onset of new signs and symptoms or the progression of existing ones are both vital to timely recognition of pregnancy-specific CVDs. For a synopsis of key diagnostic criteria for the pregnancy-specific CVDs discussed in this article, see Table 1 (Abildgaard et Heimdal, 2013;Butalia et al, 2018;Hibbard et al, 1999;Pfaff, 2014;Sibai, 2003).…”

Effects of blood pressure level management on maternal and perinatal outcomes in pregnant women with mild to moderate gestational hypertension

“…The prevention, early diagnosis, and treatment of HDCP can reduce the risk of maternal and fetal complications [9][10][11]. In most regions of the world, severe gestational hypertension was diagnosed when the blood pressure during pregnancy is more than 160/110 mm Hg [12][13][14]. It has reached a consensus on the antihypertensive treatment of severe gestational hypertension, and it is necessary to control the blood pressure when the severe gestational hypertension occurs.…”

“…According to the report of the American College of Obstetricians and Gynecologists' Task Force on hypertension in pregnancy, it is suggested that anti-hypertensive medications not be administered for women with mild gestational hypertension or preeclampsia with a persistent blood pressure of less than 160/110 mm Hg [12]. Whereas some other countries, such as Canada, Australia, China, and so on, believe that the treatment of anti-hypertensive can also be considered in women with mild-moderate gestational hypertensive [13][14][15]. Therefore, to optimize the management of blood pressure in pregnancies with mild-moderate hypertensive is necessary for reducing maternal and perinatal morbidity and mortality.…”