This document summarizes chronic hypertension in pregnancy. It notes that chronic hypertension means high blood pressure before the 20th week of pregnancy or beyond 12 weeks after delivery. For low-risk women, lifestyle modifications like exercise restrictions can lead to satisfactory outcomes without medication. Risk factors for complications include age over 40, long-standing hypertension over 15 years, high blood pressure levels, other medical conditions, and thrombophilias. Chronic hypertension can cause preeclampsia/eclampsia in the mother and issues like growth restriction or fetal death. Prenatal care includes testing, rest, potential antihypertensives, and observation. Recommended medications include methyldopa, certain beta blockers, and hydralazine, while A

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! !