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Williams Obstetrics, 23e
| Section VII. Obstetrical Complications > |
Chapter 34. Pregnancy Hypertension
Sections: Pregnancy Hypertension: Introduction, Terminology and Classification, Diagnosis, Incidence and Risk Factors, Etiopathogenesis, Pathophysiology, Prediction and Prevention, Management, Long-Term Consequences, References.
Topics Discussed: hypertension; hypertension in pregnancy; hypertension, pregnancy-induced.
Excerpt:"Hypertensive disorders complicate 5 to 10 percent of all pregnancies, and together they form one member of the deadly triad, along with hemorrhage and infection, that contribute greatly to maternal morbidity and mortality rates. With hypertension, the preeclampsia syndrome, either alone or superimposed on chronic hypertension, is the most dangerous. As subsequently discussed, new-onset nonproteinuric hypertension during pregnancy—termed gestational hypertension—is followed by signs and symptoms of preeclampsia almost half the time, and preeclampsia is identified in 3.9 percent of all pregnancies (Martin and colleagues, 2009). The World Health Organization systematically reviews maternal mortality worldwide (Khan and colleagues, 2006). In developed countries, 16 percent of maternal deaths were due to hypertensive disorders. This percentage is greater than three other leading causes: hemorrhage—13 percent, abortion—8 percent, and sepsis—2 percent. In the United States from 1991 to 1997, Berg and colleagues (2003) reported that almost 16 percent of 3201 maternal deaths were from complications of pregnancy-related hypertension. Importantly, Berg and co-workers (2005) later reported that over half of these hypertension-related deaths were preventab..."
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