ABSTRACT
Hypertensive disorders occur in 12-22% of all pregnancies1, making them one of the most common medical complications of pregnancy. Of equal and perhaps greater importance, hypertensive disorders are directly responsible for significant maternal and neonatal morbidity, and they have been implicated in approximately 20% of maternal deaths1,2. Recently, the definitions for gestational hypertension (elevated blood pressure without proteinuria after 20 weeks and returning to normal postpartum) and preeclampsia (gestational hypertension with proteinuria) superseded commonly used terminology such as pregnancy-induced hypertension (PIH), which is not only vague, but also had been used widely1. Although the precise pathophysiology for these conditions remains unclear, the common denominator for all patients is the placenta. Nulliparity, chronic hypertension or underlying cardiovascular disease, and extremes of maternal age remain risk factors for developing hypertensive complications. As patients with multiple gestations have increased placental mass and are increasingly likely to be nulliparous and older, it is not surprising that the incidence of gestational hypertension and pre-eclampsia (PEC) among these women is significantly increased, compared with that of women carrying a singleton3-8.
