Prevention and Treatment of Hypertension in Pregnancy

Hypertension in pregnancy is defined as a blood pressure of greater than or equal to 140 mmHg (systolic) or 90 mmHg (diastolic) on at least two measurements, ideally separated by a period of rest. Severe hypertension is defined as a blood pressure of greater than 160–170/110 mmHg. Systolic hypertension of greater than 180 mmHg is a medical emergency.¹

Hypertensive disorders of pregnancy can be subclassified into four groups – chronic hypertension, gestational hypertension, preeclampsia, and superimposed preeclampsia in the setting of chronic hypertension, as laid out in the ACOG (American Congress of Obstetricians and Gynecologists) guideline.²

Preeclampsia is a global health problem of increasing significance.^3,4 Preeclampsia complicates 2%–8% of all pregnancies, contributes to 15% of preterm deliveries, and between 9% and 26% of maternal deaths worldwide.⁵ Pre-eclampsia is the most dangerous of the HDPs; world-wide, each year, pre-eclampsia is responsible for over 500,000 fetal and neonatal deaths and over 70,000 maternal deaths.⁶

In Egypt, complications of hypertensive disorders with pregnancy are responsible for 15% of the causes of maternal mortality, second only to postpartum hemorrhage.⁷

Optimization of health care for women during pregnancy to prevent and treat hypertensive disorders of pregnancy is a necessary step towards achievement of the Millennium Development Goals.