Hypertension, pre-eclampsia and eclampsia: Monitoring and outcome of pregnancy

Pregnancy-induced hypertension, pre-eclampsia and eclampsia are parts of the hypertensive syndrome which is a life-threatening condition both for mother and fetus. Apart from being associated with unpredictable onset, it is incurable, except by ending the pregnancy. Its incidence is approximately between 6 - 10% of pregnant women. There is no unique definition and classification of the hypertensive syndrome in pregnancy, i.e. they differ from one expert group to another. RISKS OF PREGNANCY-INDUCED HYPERTENSION: Pregnancy-induced hypertension syndrome can cause placental abruption, intracranial hemorrhage, liver lesions, acute renal disorders and disseminated intravascular coagulation (DIC), adult respiratory distress syndrome (ARDS), hypervolemia and inhalation of gastric content, due to deep sedation. TREATMENT OF PREGNANCY-INDUCED HYPERTENSION: Delivery is always appropriate therapy for the mother, but may not be a good solution for the fetus. Standard treatment of preeclampsia includes: anticonvulsive therapy, antihypertensive therapy, excessive fluid administration, and if necessary, management of oliguria, DIC, pulmonary edema and recovery of liver function. THE OUTCOME OF PREGNANCY-INDUCED HYPERTENSION (PERINATAL AND MATERNAL MORTALITY): Maternal mortality due to pregnancy-induced hypertension is 15 - 33% out of the total number of maternal deaths. Newborn infants of mothers with pregnancy-induced hypertension present with intrauterine growth retardation, prematurity, dysmaturity and necrotizing enterocolitis. Pregnancy-induced hypertension is one of the major causes of maternal and fetal/neonatal morbidity and mortality.