Hypertension in pregnancy

Abstract

Hypertension is a common complication of pregnancy. Maternal and foetal outcomes depend upon the nature of the hypertension affecting the pregnancy, which can range from mild gestational hypertension to severe preeclampsia with its associated multisystemic complications. Preeclampsia is a leading cause of maternal mortality. The World Health Organization estimates that, worldwide, over 100 000 women die from preeclampsia each year, and the condition has remained one of the leading causes of maternal death in the UK over recent decades. Features of substandard care were shown in 46% of the 14 deaths associated with preeclampsia or eclampsia in the last report on Confidential Enquiries into Maternal Deaths in the UK. Intracranial haemorrhage was the single largest cause of death, reflecting a failure of effective antihypertensive therapy and in particular ineffectual treatment of the raised systolic blood pressure. Although recent research has clarified the underlying aetiology of this condition, this has disappointingly not yet translated into a clinical useful prevention strategy. There is a clear need for greater awareness of the causes and optimal management of this common condition.