Chronic hypertension in pregnancy: synthesis of influential guidelines

医学 子痫前期 怀孕 卓越 妊娠高血压 妇产科学 产科 重症监护医学 产前护理 妊娠高血压 儿科 人口 环境卫生 法学 生物 遗传学 政治学
作者
Ιoannis Tsakiridis,Sonia Giouleka,Alexandra Arvanitaki,Apostolos Mamopoulos,George Giannakoulas,Georgios Papazisis,Apostolos Athanasiadis,Themistoklis Dagklis
出处
期刊:Journal of Perinatal Medicine [De Gruyter]
卷期号:49 (7): 859-872 被引量:21
标识
DOI:10.1515/jpm-2021-0015
摘要

Chronic hypertension in pregnancy accounts for a substantial proportion of maternal morbidity and mortality and is associated with adverse perinatal outcomes, most of which can be mitigated by appropriate surveillance and management protocols. The aim of this study was to review and compare recommendations of published guidelines on this condition. Thus, a descriptive review of influential guidelines from the National Institute for Health and Care Excellence, the Society of Obstetric Medicine of Australia and New Zealand, the International Society of Hypertension, the International Society for the Study of Hypertension in Pregnancy, the European Society of Cardiology, the International Federation of Gynecology and Obstetrics, the Society of Obstetricians and Gynaecologists of Canada and the American College of Obstetricians and Gynecologists on chronic hypertension in pregnancy was conducted. All guidelines agree on the definition and medical management, the need for more frequent antenatal care and fetal surveillance and the re-evaluation at 6-8 weeks postpartum. There is also a consensus that the administration of low-dose aspirin is required to prevent preeclampsia, although the optimal dosage remains controversial. No universal agreement has been spotted regarding optimal treatment blood pressure (BP) targets, need for treating mild-to-moderate hypertension and postnatal BP measurements. Additionally, while the necessity of antenatal corticosteroids and magnesium sulfate for preterm delivery is universally recommended, the appropriate timing of delivery is not clearly outlined. Hence, there is a need to adopt consistent practice protocols to optimally manage these pregnancies; i.e. timely detect and treat any potential complications and subsequently reduce the associated morbidity and mortality.
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