Tight control of mild-moderate pre-existing or non-proteinuric gestational hypertension

Nabhan, Ashraf; Elsedawy, Maged M

doi:10.1002/14651858.cd006907.pub2

Cited by 18 publications

(10 citation statements)

References 23 publications

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“…116,123,124 A Cochrane systematic review on the control of blood pressure in mild to moderate PIH did not reach conclusive results due to insufficient data. 125 In general, non-pharmacological treatment is suggested for pregnant women with mild to moderate PIH that do not fulfil the criteria for pharmacologic treatment. According to the WHO, lifestyle modification, such as strict bed rest and salt restriction, are not recommended in PIH or PE.…”

Section: Mild To Moderate Hypertensionmentioning

confidence: 99%

Pregnancy-Induced hypertension

et al. 2015

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pregnancy-induced hypertension (pIh) complicates 6-10% of pregnancies. It is defined as systolic blood pressure (sbp) >140 mmhg and diastolic blood pressure (dbp) >90 mmhg. It is classified as mild (sbp 140-149 and dbp 90-99 mmhg), moderate (sbp 150-159 and dbp 100-109 mmHg) and severe (SBP ≥160 and DBP ≥110 mmHg). PIH refers to one of four conditions: a) pre-existing hypertension, b) gestational hypertension and preeclampsia (pe), c) pre-existing hypertension plus superimposed gestational hypertension with proteinuria and d) unclassifiable hypertension. pIh is a major cause of maternal, fetal and newborn morbidity and mortality. women with pIh are at a greater risk of abruptio placentae, cerebrovascular events, organ failure and disseminated intravascular coagulation. fetuses of these mothers are at greater risk of intrauterine growth retardation, prematurity and intrauterine death. ambulatory blood pressure monitoring over a period of 24 h seems to have a role in predicting deterioration from gestational hypertension to pe. antiplatelet drugs have moderate benefits when used for prevention of pe. treatment of pIh depends on blood pressure levels, gestational age, presence of symptoms and associated risk factors. non-drug management is recommended when sbp ranges between 140-149 mmhg or dbp between 90-99 mmhg. blood pressure thresholds for drug management in pregnancy vary between different health organizations. according to 2013 esh/esc guidelines, antihypertensive treatment is recommended in pregnancy when blood pressure levels are ≥150/95 mmHg. Initiation of antihypertensive treatment at values ≥140/90 mmHg is recommended in women with a) gestational hypertension, with or without proteinuria, b) pre-existing hypertension with the superimposition of gestational hypertension or c) hypertension with asymptomatic organ damage or symptoms at any time during pregnancy. methyldopa is the drug of choice in pregnancy. atenolol and metoprolol appear to be safe and effective in late pregnancy, while labetalol has an efficacy comparable to methyldopa. angiotensin-converting enzyme (ace) inhibitors and angiotensin II antagonists are contraindicated in pregnancy due to their association with increased risk of fetopathy.

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Section: Mild To Moderate Hypertensionmentioning

confidence: 99%

Pregnancy-Induced hypertension

et al. 2015

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“…En la Guía de la ACC/AHA del 2017 se refiere que existen 3 revisiones en la base de datos Cochrane sobre el tratamiento de la hipertensión leve a moderada durante embarazo (22,26,27) ; el tratamiento de dicha categoría de hipertensión reduce el riesgo de progresión a hipertensión severa en 50% en comparación con el placebo; tabla 1. estudio Fetomaterno en caso de Hipertensión en la gestación.…”

Section: El Estudio Chips (Control Of Hypertension In Preg-unclassified

Hipertensión en el embarazo

Moncloa¹,

Valdivia²,

Rodríguez³

et al. 2018

Rev peru ginecol obstet.

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Los trastornos hipertensivos durante el embarazo son complicaciones muy frecuentes consideradas causa importante de morbilidad y mortalidad materna y/o fetal. Sobre el manejo de la hipertensión durante la gestación, las diversas guías actuales coinciden en tratar la presión arterial si es ≥ 160/105-110 mmHg por el elevado riesgo de accidente cerebrovascular (stroke) asociado, y en normalizar la presión a < 140/90 si hay compromiso de órgano blanco. Sobre el tratamiento de la hipertensión leve-moderada, la evidencia concluye que reduce el riesgo de desarrollar hipertensión no controlada, pero no previene la preeclampsia. En lo que se refiere a la elección de un fármaco, entre los agentes recomendados, ningún agente específico es la primera opción porque no hay datos que apoyen uno sobre otro.

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“…[10][11][12] • Mild to moderate hypertension: Nonpharmacologic treatment is recommended. According to the Cochrane database, [13][14][15] treatment of mild-to-moderate hypertensionduringpregnancywithantihypertensive reducesthe riskofprogressiontoseverehypertensionby50%butdoes not prevent preeclampsia. Another large multinational RCT also supports this fact.…”

Section: Treatment and Managementmentioning

confidence: 99%

Hypertensive Disorders in Pregnancy

Nemani

2018

Ind J Car Dis Wom

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Hypertension in pregnancy is defined as systolic blood pressure (SBP) ≥ 140 mm Hg or diastolic blood pressure (DBP) ≥ 90 mm Hg or both on two different occasions at least 6 hours apart. Severe hypertension is SBP ≥ 160 mm Hg or DBP ≥ 110 mm Hg. Hypertension is the most common medical problem in pregnancy and one of the major causes of maternal and perinatal mortality and morbidity. Hypertensive disorders in pregnancy (HDP) are classified as (1) chronic hypertension, (2) chronic hypertension with superimposed preeclampsia, (3) preeclampsia-eclampsia, and (4) gestational hypertension. HDP contributes to increased risk of hypertension, stroke, and maternal cardiovascular disease (CVD) in later life. HDP can be considered as a failed cardiovascular stress test identifying women susceptible to CVD in later life. Further research is required to identify the mechanisms in HDP that contribute to CVD in later life so as to initiate appropriate prevention measures.

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Tight control of mild-moderate pre-existing or non-proteinuric gestational hypertension

Abstract: For pregnant women with non-severe pre-existing or non-proteinuric gestational hypertension, there is insufficient evidence to determine how tight control of hypertension should be achieved to improve maternal and fetal-neonatal outcomes.

Cited by 18 publications

References 23 publications

Pregnancy-Induced hypertension

Pregnancy-Induced hypertension

Hipertensión en el embarazo

Hypertensive Disorders in Pregnancy

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