Hypertension in pregnancy

1. I H E K A C H I S O M , G R O U P 6 3 8
Chronic hypertension in pregnancy

2. • Chronic hypertension means the presence of hypertension of any cause antedating or before the
20th week of pregnancy beyond the 12 weeks of delivery.
• Women with chronic hypertension are low risk and have satisfactory maternal and fetal outcome
without any hypertensive therapy by life style modification
• With lifestyle modification, aerobic exercise should be restricted based on theoretical terms.
Intorduction

3. • Age (>40)
• Duration of hypertension (>15years )
• Level of BP (160/110mmHg)
• Presence of any medical condition
• Presence of thrombophillas
Risk factors

4. • Maternal:
• Superimposed pre -eclampsia/eclampsia in 15 -20% of cases.
• Fetal:
• Intrauterine growth retardation
• Intrauterine f etal death.
Effect of chronic hypertension on
pregnancy

5. Pre natal care for chronic hypertensives / treatment
• ECG should be obtained in women with
long standing hypertension
• Baseline lab test:
• Urinalysis, urine culture and serum
creatinine, glucose and electrolytes.
• Women with proteinuria on a urine dipstick
should have a quantitative test for urine
protein.
• Rest
• Anti hypertensives
• Observation
GENERAL AND MEDICAL TREATMENT

6. Medical treatment
AGENT COMMENTS
• Methyldopa(250mg/d in 2 divided
doses)
• Beta blockers(labetolol 100mg/BID,
maximum dose of 2400mg/day)
• Hydralazine (50-300mg/d in 2-4
divided dose)
• Preferred based on long term follow up
studies supporting safety
• Generally safe (labetolol only)
• Safe to use

7. Contraindicated drugs
AGENT COMMENTS
• ACEIs and ARB’s
• Diuretics
• Reserpine
• Sodium nitroprusside
• Non selective beta blockers
• Causes oligohydraminos and cause
fetal toxicity and death.
• Neonatal hypotension
• Intrauterine growth retardation

8. Thank you! !