Clinical features and prenatal risk factors for hypertensive disorders in twin pregnancies

Abstract

One-fifth of the twin pregnancies developed GH or PE. Furthermore, more than half of the patients were diagnosed with the disease during the intrapartum or postpartum period. Significant risk factors for GH or PE in twin pregnancies were primiparity, pregestational body mass index, family history of hypertension, and history of a hypertensive disorder during a previous pregnancy. The significance of monitoring blood pressure after delivery for a twin pregnancy is stressed.

Incidence of and risk factors for severe maternal complications associated with hypertensive disorders after 36 weeks’ gestation in uncomplicated twin pregnancies: A prospective cohort study

“…In particular, from 36 to 38 weeks' gestation, the prevalence of severe HD tended to increase from 2.8 to 4.7% (data not shown in the original article). 10 The prevalence of severe maternal complications mostly consisting of severe HD also significantly increased in this study. Life-threatening events did not occur other than each one case of placental abruption, HELLP syndrome and eclampsia, and the maternal short-term outcomes, that is, mortality and neurological morbidity, were favorable; however, severe HD might progress to more serious complications, such as cerebral hemorrhage, renal failure, pulmonary edema, eclampsia or placental abruption.…”

“…In our previous study including 742 twin pregnancies, HD prevalence was 22%, and the disease developed after 32 weeks’ gestation in 97% of cases. In particular, from 36 to 38 weeks’ gestation, the prevalence of severe HD tended to increase from 2.8 to 4.7% (data not shown in the original article) . The prevalence of severe maternal complications mostly consisting of severe HD also significantly increased in this study.…”

“…Hypertensive disorders (HD) in twin pregnancies mostly consisted of gestational hypertension, and preeclampsia was two to three times higher than that in singleton pregnancies 8,9 ; most HD in twin pregnancies developed during the latter half of the third trimester. 10 Moreover, abnormal results of the maternal coagulation-fibrinolysis function test were observed more frequently at the latter half of the 3rd trimester in twin pregnancies than in singleton pregnancies. 11,12 These abnormalities were reported to be followed by impaired maternal liver function, which might progress to HELLP (hemolysis, elevated liver enzyme and low platelet) syndrome.…”

“…Meanwhile, maternal risks according to gestational age associated with the continuation of pregnancy to term have not been fully evaluated in twin pregnancies. Hypertensive disorders (HD) in twin pregnancies mostly consisted of gestational hypertension, and pre‐eclampsia was two to three times higher than that in singleton pregnancies; most HD in twin pregnancies developed during the latter half of the third trimester . Moreover, abnormal results of the maternal coagulation‐fibrinolysis function test were observed more frequently at the latter half of the 3rd trimester in twin pregnancies than in singleton pregnancies .…”

Materno-fetal outcomes in pre eclampsia in a rural hospital of Antananarivo Madagascar

“…7 Similarly, preeclampsia and pregnancy-induced hypertension occur more frequently in primiparous women. 8,9 In this study the mean age of the parturient was 28 years old. It is probably because we are dealing with women from rural developing country, where early marriage is more common.…”