183. Severe hypertension and maternal organ involvements were closely related in the disease of hypertensive disorders of pregnancy

Abstract

Purpose Severe hypertension (sevHT, over 160/110 mmHg) is supposed to be pathogenesis of maternal organ involvements in the disease of hypertensive disorders of pregnancy. It remains that to what extent each target organ is to be damaged in sevHT. Methods 2746 pregnant women managed in our tertial perinatal center from 2013 to 2016 were entered in this study retrospectively. All cases with sevHT were managed expectantly in the same antihypertensive protocol. Disease type was defined by restrictive criteria in irrespective of organ involvements. Result 192 cases of 2746 found sevHT and 91 cases was in antepartum (AP), 90 in intrapartum (IP) and 21 in postpartum (PP). 9 cases (11%) of 91 cases in AP showed gestational hypertension (GH), 47 (58%) preeclampsia and 22 (27%) preeclampsia superimposed on chronic hypertension (PES). 11% of GH in AP, 58% of PE in AP, 41% of PES in AP, 11% in IP and 29% in PP complicated with organ involvements. HELLP related involvements such as elevated liver enzymes, low platelets count or renal impairment were observed in 34% of PE in AP, 27% of PES in AP and 14% in PP. Hyperpermeability involvements such as pleural edema or massive ascites were diagnosed in 9% of PE or PES in AP. About CNS involvements, eclampsia were observed in 4% of PE in AP, cerebral vascular spasms 6% of PE in AP, 5% of PES in AP, 1% in IP and 14% in PP. Conclusions SevHT found in 7% (192 of 2746). CNS involvements found 9% of preeclamptic disease. HELLP related involvements related to the preeclamptic disease. Hyperpermeability involvements had even 11% in GH in preeclamptic disease. We showed maternal organ involvements were closely related with preeclamptic disease with sevHT. Also hyperpermeability involvements related with GH with sevHT. In discussing non-proteinuric preeclampsia, hyperpermeability disorders play important role.