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Intensification of fetal and maternal surveillance in pregnant women with hypertensive disorders
Author(s) -
Knuist M,
Bonsel G.J,
Zondervan H.A,
Treffers P.E
Publication year - 1998
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/s0020-7292(98)00024-1
Subject(s) - medicine , obstetrics , blood pressure , gestational hypertension , preeclampsia , hellp syndrome , pregnancy , proteinuria , eclampsia , gestational age , gestation , diastole , biology , genetics , kidney
Objective: To examine the need to intensify fetal and maternal surveillance in pregnant women with mild pregnancy hypertension. Methods: The multi‐center cohort study in 2413 healthy nulliparae analyzed differences in hypertension‐related adverse events (small‐for‐gestational age, perinatal mortality, eclampsia, abruptio placentae and HELLP syndrome) according to maximum diastolic blood pressure and proteinuria. Results: Compared to the reference group (diastolic blood pressure 70–85 mmHg) ( n =1882) the relative risks of adverse fetal and maternal outcome in 34 proteinuric hypertensive women were 8.9 (95% CI 3.3–24.1) and 41.5 (95% CI 9.7–178.4), respectively. In 203 non‐proteinuric women with a maximum diastolic blood pressure of ≥95 mmHg only the relative risk of adverse maternal outcome was increased (11.6, 95% CI 3.1–42.8), but it was not increased in 230 non‐proteinuric women with a maximum diastolic of 90 mmHg. Conclusions: Intensified surveillance in women with mild pregnancy hypertension is not indicated and should be reserved for groups with increased fetal and maternal risk.