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1、Hypertensivedisordersinpregnancyremainamajorcauseofmaternal,fetal,andneonatalmorbidityandmortalityindevelopingandindevelopedcountries.Thesewomenareathigherriskforseverecomplicationssuchasabruptioplacentae,cerebrovascularaccident,organfailure,anddisseminatedi
2、ntravascularcoagulation.Thefetusisatriskforintrauterinegrowthretardation,prematurity,andintrauterinedeath.Hypertensionisthemostcommonmedicalprobleminpregnancy,complicatingupto15%ofpregnaneiesandaccountingforaboutaquarterofallantenataladmissio1Diagnosisandris
3、kassessmentHighBPreadingsshouldbeconfirmedontwooccasions,usingmercurysphygmomanometry(KorotkoffVforreadingDBP)inthesittingposition,orananeroiddevice.BPmeasurementsintheleftlateralrecumbencyareareasonablealternative.Onlyvalidatedmeasuringdevicesandvalidatedam
4、bulatoryBPmonitoring(ABPM)devicesshouldbeused.Hypertensioninpregnancy,asdiagnosedbyABPM,issuperiortotheofficemeasurementofBPinpredictingoutcomes?Basiclaboratoryinvestigationsrecommendedformonitoringpregnantpatientswithhypertensionincludeurinalysis,bloodcount
5、,haematocrit,liverenzymes?serumcreatinine,andserumuricacid.Proteinuriashouldbestandardizedin24hurinecollection(if.2g/day,closemonitoringiswarranted;if.3g/day,deliveryshouldbeconsidered).Ultrasoundinvestigationoftheadrenalsandurinemetanephrineandnormetanephri
6、neassaysmaybeconsideredinpregnantwomenwithhypertensiontoexcludepheochromocytomawhichmaybeasymptomaticand,ifnotdiagnosedbeforelabouI*,fatal.Dopplerultrasoundofuterinearteries,performedduringthesecondtrimester(.16weeks),isusefultodetectuteroplacentalhypoperfus
7、ion,whichisassociatedwithahigherriskofpre-eclampsiaandintrauterinegrowthretardation,inbothhighriskandlowriskwomen.1DefinitionandclassificationofhypertensioninpregnancyThedefinitionofhypertensioninpregnancyisbasedonabsoluteBPvalues(SBP>140mmHgorDBP>90mmHg).an
8、ddistinguishesmildly(140-159/90-109mmHg)orseverely(>160/110mmHg)elevatedBP,incontrasttothegradesusedbytheEuropeanSocietyofHypertension(ESH)/ESC?orothers.Hypertensioninpregnancyisnotasingleentity
