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Chapter 25 - Hypertensive Disorders in Pregnancy and Eclampsia

from Section 4 - Maternal Medicine

Published online by Cambridge University Press:  20 November 2021

Tahir Mahmood
Affiliation:
Victoria Hospital, Kirkcaldy
Charles Savona Ventura
Affiliation:
University of Malta, Malta
Ioannis Messinis
Affiliation:
University of Thessaly, Greece
Sambit Mukhopadhyay
Affiliation:
Norfolk & Norwich University Hospital, UK
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Summary

Hypertensive disorders of pregnancy (HDP) remain a major obstetric challenge across the world. No other antenatal complication is both so common and dangerous for the mother and baby together. Hypertension is the commonest medical problem encountered in pregnancy, and affects 10–15% of all pregnancies. Hypertension in pregnancy is divided into pre-existing hypertension (chronic hypertension), gestational hypertension (previously named pregnancy induced hypertension) and pre-eclampsia. Pre-eclampsia is the most severe HDP form, with great mortality and morbidity risk for the mother and offspring, especially in countries with inadequate antenatal care.

Type
Chapter
Information
The EBCOG Postgraduate Textbook of Obstetrics & Gynaecology
Obstetrics & Maternal-Fetal Medicine
, pp. 201 - 212
Publisher: Cambridge University Press
Print publication year: 2021

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References

Mol, BW, Roberts, CT, Thangaratinam, S, et al. Pre-eclampsia. Lancet. 2015; 387: 9991011.CrossRefGoogle ScholarPubMed
Poon, LC, Shennan, A, Hyett, JA, et al. The International Federation of Gynecology and Obstetrics (FIGO) initiative on pre-eclampsia: A pragmatic guide for first-trimester screening and prevention. Int J Gynaecol Obstet. 2019; 145 Suppl 1: 133.Google Scholar
Duley, L. The global impact of pre-eclampsia and eclampsia. Semin Perinatol. 2009; 33: 130–7.Google Scholar
Brown, MA, Magee, LA, Kenny, LC, et al. Hypertensive disorders of pregnancy: ISSHP classification, diagnosis, and management recommendations for international practice. Hypertension. 2018; 72: 2443.CrossRefGoogle ScholarPubMed
Lawn, JE, Blencowe, H, Pattinson, R, et al. Stillbirths: where? when? why? how to make the data count? Lancet. 2011; 377: 1448–63.CrossRefGoogle ScholarPubMed
Sibai, BM. Preeclampsia as a cause of preterm and late preterm (near-term) births. Semin Perinatol. 2006; 30: 16–9.Google Scholar
Ghulmiyyah, L, Sibai, B. Maternal mortality from preeclampsia/eclampsia. Semin Perinatol. 2012; 36: 56–9.CrossRefGoogle ScholarPubMed
Nyflot, LT, Ellingsen, L, Yli, BM, Oian, P, Vangen, S. Maternal deaths from hypertensive disorders: lessons learnt. Acta Obstet Gynecol Scand. 2018; 97: 976–87.CrossRefGoogle ScholarPubMed
van den Akker, T, Bloemenkamp, KWM, van Roosmalen, J, Knight, M. Classification of maternal deaths: where does the chain of events start? Lancet. 2017; 390: 922–3.Google Scholar
Lowe, SA, Bowyer, L, Lust, K, et al. SOMANZ guidelines for the management of hypertensive disorders of pregnancy 2014. Aust N Z J Obstet Gynaecol. 2015; 55: e129.Google ScholarPubMed
Hypertension in pregnancy. Report of the American College of Obstetricians and Gynecologists’ Task Force on Hypertension in Pregnancy. Obstet Gynecol. 2013; 122: 1122–31.Google Scholar
Staff, AC, Andersgaard, AB, Henriksen, T, et al. Chapter 28 Hypertensive disorders of pregnancy and eclampsia. Eur J Obstet Gynecol Reprod Biol. 2016; 201: 171–8.Google Scholar
Bramham, K, Parnell, B, Nelson-Piercy, C, et al. Chronic hypertension and pregnancy outcomes: systematic review and meta-analysis. BMJ. 2014; 348: g2301.Google Scholar
Klungsoyr, K, Morken, NH, Irgens, L, Vollset, SE, Skjaerven, R. Secular trends in the epidemiology of pre-eclampsia throughout 40 years in Norway: prevalence, risk factors and perinatal survival. Paediatr Perinat Epidemiol. 2012; 26: 190–8.Google Scholar
Sibai, BM. Diagnosis and management of gestational hypertension and preeclampsia. Obstet Gynecol. 2003; 102: 181–92.Google ScholarPubMed
Saftlas, AF, Olson, DR, Franks, AL, Atrash, HK, Pokras, R. Epidemiology of preeclampsia and eclampsia in the United States, 1979–1986. Am J Obstet Gynecol. 1990; 163: 460–5.Google Scholar
Andersgaard, AB, Herbst, A, Johansen, M, et al. Eclampsia in Scandinavia: incidence, substandard care, and potentially preventable cases. Acta Obstet Gynecol Scand. 2006; 85: 929–36.Google Scholar
Roberts, CL, Ford, JB, Algert, CS, et al. Population-based trends in pregnancy hypertension and pre-eclampsia: an international comparative study. BMJ Open. 2011; 1: e000101.Google Scholar
Redman, CW. Current topic: pre-eclampsia and the placenta. Placenta. 1991; 12: 301–8.Google Scholar
Redman, CW, Sargent, IL, Staff, AC. IFPA Senior Award Lecture: Making sense of pre-eclampsia – Two placental causes of preeclampsia? Placenta. 2014; 35 Suppl: S20-S5.Google Scholar
Redman, CW, Staff, AC. Preeclampsia, biomarkers, syncytiotrophoblast stress, and placental capacity. Am J Obstet Gynecol. 2015; 213: S9-4.Google Scholar
Staff, AC. The two-stage placental model of preeclampsia: an update. J Reprod Immunol. 2019; 134 –135:110.Google Scholar
Staff, AC, Redman, C. The differences between early- and late-onset preeclampsia. In Saito, S, ed. Preeclampsia. Singapore: Springer; 2018. pp. 157–72.Google Scholar
Moffett, A, Hiby, SE. How does the maternal immune system contribute to the development of pre-eclampsia? Placenta. 2007; 28 Suppl A: S51–S6.CrossRefGoogle Scholar
Maynard, SE, Min, JY, Merchan, J, et al. Excess placental soluble fms-like tyrosine kinase 1 (sFlt1) may contribute to endothelial dysfunction, hypertension, and proteinuria in preeclampsia. J Clin Invest. 2003; 111: 649–58.Google Scholar
Ness, RB, Roberts, JM. Heterogeneous causes constituting the single syndrome of preeclampsia: a hypothesis and its implications. Am J Obstet Gynecol. 1996; 175: 1365–70.CrossRefGoogle ScholarPubMed
Hammer, ES, Cipolla, MJ. Cerebrovascular dysfunction in preeclamptic pregnancies. Curr Hypertens Rep. 2015; 17: 64.Google Scholar
Thilaganathan, B. Pre-eclampsia is primarily a placental disorder: AGAINST: Pre-eclampsia: the heart matters. BJOG. 2017; 124: 1763.CrossRefGoogle ScholarPubMed
Nelson-Percy, C. Handbook of Obstetric Medicine. London: CRC Press, Taylor and Francis Group; 2015.Google Scholar
Visintin, C, Mugglestone, MA, Almerie, MQ, et al. Management of hypertensive disorders during pregnancy: summary of NICE guidance. BMJ. 2010; 341: c2207.Google Scholar
Duhig, KE, Myers, J, Seed, PT, et al. Placental growth factor testing to assess women with suspected pre-eclampsia: a multicentre, pragmatic, stepped-wedge cluster-randomised controlled trial. Lancet. 2019; 393: 1807–18.Google Scholar
Chappell, LC, Duckworth, S, Seed, PT, et al. Diagnostic accuracy of placental growth factor in women with suspected preeclampsia: a prospective multicenter study. Circulation. 2013; 128: 2121–31.Google Scholar
Zeisler, H, Llurba, E, Chantraine, F, et al. Predictive value of the sFlt-1: PlGF ratio in women with suspected preeclampsia. N Engl J Med. 2016; 374: 1322.CrossRefGoogle ScholarPubMed
Bramham, K, Seed, PT, Lightstone, L et al. Diagnostic and predictive biomarkers for pre-eclampsia in patients with established hypertension and chronic kidney disease. Kidney Int. 2016; 89: 874–85.Google Scholar
National Institute for Health and Care Excellence (NICE). Hypertension in Pregnancy: Diagnosis and Management. NICE Guideline 133. 2019Google Scholar
Abalos, E, Duley, L, Steyn, DW, Gialdini, C. Antihypertensive drug therapy for mild to moderate hypertension during pregnancy. Cochrane Database Syst Rev. 2018; 10: Cd002252.Google Scholar
Magee, LA, von Dadelszen, P, Rey, E, et al. Less-tight versus tight control of hypertension in pregnancy. N Engl J Med. 2015; 372: 407–17.Google Scholar
Easterling, T, Mundle, S, Bracken, H, et al. Oral antihypertensive regimens (nifedipine retard, labetalol, and methyldopa) for management of severe hypertension in pregnancy: an open-label, randomised controlled trial. Lancet. 2019; 394: 1011–21.CrossRefGoogle ScholarPubMed
Broekhuijsen, K, van Baaren, GJ, van Pampus, MG, et al. Immediate delivery versus expectant monitoring for hypertensive disorders of pregnancy between 34 and 37 weeks of gestation (HYPITAT-II): an open-label, randomised controlled trial. Lancet. 2015; 385: 2492–501.Google Scholar
Bernardes, TP, Zwertbroek, EF, Broekhuijsen, K, et al. Delivery or expectant management for prevention of adverse maternal and neonatal outcomes in hypertensive disorders of pregnancy: an individual participant data meta-analysis. Ultrasound Obstet Gynecol. 2019; 53: 443–53.Google Scholar
Chappell, LC, Green, M, Marlow, N, et al. Planned delivery or expectant management for late preterm pre-eclampsia: study protocol for a randomised controlled trial (PHOENIX trial). Trials. 2019; 20: 85.Google Scholar
Koopmans, CM, Bijlenga, D, Groen, H, et al. Induction of labour versus expectant monitoring for gestational hypertension or mild pre-eclampsia after 36 weeks’ gestation (HYPITAT): a multicentre, open-label randomised controlled trial. Lancet. 2009; 374: 979–88.CrossRefGoogle ScholarPubMed
Duley, L, Gulmezoglu, AM, Henderson-Smart, DJ, Chou, D. Magnesium sulphate and other anticonvulsants for women with pre-eclampsia. Cochrane Database Syst Rev. 2010; 2010(11): CD000025.Google ScholarPubMed
Rolnik, DL, Wright, D, Poon, LC, et al. Aspirin versus placebo in pregnancies at high risk for preterm preeclampsia. N Engl J Med. 2017; 377: 613–22.Google Scholar
Staff, AC, Redman, CW, Williams, D, et al. Pregnancy and long-term maternal cardiovascular health: progress through harmonization of research cohorts and biobanks. Hypertension. 2016; 67: 251–60.Google Scholar
NICE. Hypertension in Pregnancy Overview. NICE Pathways. 2017.Google Scholar
Egeland, GM, Klungsoyr, K, Oyen, N, et al. Preconception cardiovascular risk factor differences between gestational hypertension and preeclampsia: Cohort Norway Study. Hypertension. 2016; 67: 1173–80.Google Scholar
Laine, K, Murzakanova, G, Sole, KB, et al. Prevalence and risk of pre-eclampsia and gestational hypertension in twin pregnancies: a population-based register study. BMJ Open. 2019; 9: e029908.Google Scholar

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