Resistant Hypertension in Pregnancy: How to Manage?

Bortolotto, Maria Rita de Figueiredo Lemos; Francisco, Rossana Pulcineli Vieira; Zugaib, Marcelo

doi:10.1007/s11906-018-0865-z

Cited by 6 publications

(5 citation statements)

References 28 publications

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“…Chronic kidney disease is the most common cause of resistant hypertension in pregnancy. 4 Normal kidney function in our patient eliminated this diagnosis. This patient did not have pre-existing hypertension, thus making treatment resistance or apparent resistance unlikely.…”

Section: Question 3: How Do These Investigations Refine the Different...mentioning

confidence: 63%

“…Optimal management strategies vary by cause. 4 , 5 , 6 , 7 , 8 In nonpregnant patients, resistant hypertension should be considered when blood pressure remains elevated at maximum or maximally tolerated doses of 3 agents, typically including a long acting calcium-channel blocker, a renin-angiotensin system (RAAS) blocker, and a diuretic agent. 3 The diagnosis is more complicated in pregnancy because RAAS blockers are contraindicated and diuretic agents are not frequently used.…”

Section: Question 2: What Is the Differential Diagnosis Of Hypertensi...mentioning

confidence: 99%

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Pheochromocytoma

Heyman,

Jayaram,

Eisenberg

et al. 2024

JACC: Case Reports

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Section: Question 3: How Do These Investigations Refine the Different...mentioning

confidence: 63%

Section: Question 2: What Is the Differential Diagnosis Of Hypertensi...mentioning

confidence: 99%

Pheochromocytoma

Heyman,

Jayaram,

Eisenberg

et al. 2024

JACC: Case Reports

View full text Add to dashboard Cite

“…An adequate calcium intake might also help to avoid superimposed pre-eclampsia in patients with resistant hypertension [13]. The mechanism by which calcium may have an effect on blood pressure is still unclear; one hypothesis is that low calcium intakes increase the levels of parathyroid hormone and 1,25-dihydroxy vitamin D, which are required to maintain specific calcium concentrations in extracellular fluids.…”

Section: Calciummentioning

confidence: 99%

Nutraceuticals and Hypertensive Disorders in Pregnancy: The Available Clinical Evidence

Fogacci

Cicero

2020

Nutrients

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The aim of the present critical review is to summarize the available clinical evidence supporting the use of some dietary supplements that have been shown to lower blood pressure in hypertensive pregnant women. A systematic search strategy was carried out to identify trials in MEDLINE (National Library of Medicine, Bethesda, Maryland, MD, USA; January 1980 to September 2019) and the Cochrane Register of Controlled Trials (The Cochrane Collaboration, Oxford, UK). The terms ‘nutraceuticals’, ‘dietary supplements’, ‘pregnancy’, ‘pre-eclampsia’, ‘clinical trial’, and ‘human’ were incorporated into an electronic search strategy. The references of the identified studies and review articles were reviewed to look for additional studies of interest. We preferably selected papers that reported recent comprehensive reviews or meta-analysis, or original clinical trials of substances with blood pressure-lowering or vascular protective effect in pregnancy. There is a relative body of evidence that supports the use of calcium, vitamin D, folic acid, and resveratrol in preventing the development of hypertensive disorders in pregnancy, and evidence supporting drug treatment too. Further clinical research is advisable to identify the dosage and timing of the supplementation, the group of women that might benefit the most from this approach, and the nutraceuticals with the best cost-effectiveness and risk-benefit ratio for widespread use in clinical practice.

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“…11 Women with raised blood pressure, prior to pregnancy should receive adequate care and attention with great detail for preventing development of complications associated with preeclampsia. 12 Eclampsia can develop at any time before, during or after parturition. The warning signs should be identified early and every effort should be taken to prevent eclampsia.…”

Section: Perinatal Detailsmentioning

confidence: 99%

Complications and pregnancy outcome in women with preeclampsia and eclampsia

Thiripurasundari¹,

Christe²,

Shobha³

et al. 2019

Int J Reprod Contracept Obstet Gynecol

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Background: One of the complications of pregnancy which till today challenges the obstetrician is preeclampsia and its severe form of eclampsia. Objective of this study was to find out the complications and outcome of pregnant women with preeclampsia and eclampsia admitted in a tertiary referral center.Methods: Case records, in labor room, were scrutinized to find out the number and the outcome of pregnancy, in women admitted with preeclampsia or eclampsia in the year 2018.Results: Pregnant women admitted with preeclampsia or eclampsia numbered 2511 and, 109 women developed complications. Maternal complications, were more often seen in mothers, (62.4%) of female babies. Only 37.6% of mothers of male babies developed complications. Complications seen were Renal complications in 34.8%, Hematological complications in 33%, Neurological complications in 25.6%, Pulmonary complications in 16.5%, ophthalmological complications in 11% and Sepsis in 6.4% and MODS in 10%. Of total maternal deaths, 34% was caused by complications of preeclampsia or eclampsia. Major cause of maternal death was MODS and Pulmonary complications. Nearly, 62.3% of babies born had birth weight of 1.8 kg and nearly one-third of babies (26.6%) were dead born.Conclusions: The incidence of preeclampsia and eclampsia in our referral center for the year 2018 was 15%, and 4.3% of women developed complications, and 6% died, making preeclampsia and eclampsia the causative factor for 34% of total maternal deaths. Major maternal complications were Renal, Hematological, Neurological, Pulmonary and MODS. Complications of preeclampsia were more often present in 62.4% mothers of female babies in contrast to 37.6% of mothers of male babies. Nearly one-third of babies (26.6%) were dead born.

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Resistant Hypertension in Pregnancy: How to Manage?

Cited by 6 publications

References 28 publications

Pheochromocytoma

Pheochromocytoma

Nutraceuticals and Hypertensive Disorders in Pregnancy: The Available Clinical Evidence

Complications and pregnancy outcome in women with preeclampsia and eclampsia

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