ABSTRACT

Hypertensive disorders in pregnancy remain a major cause of maternal, fetal and neonatal morbidity and mortality not only in developing but also in developed countries. Pregnant women with hypertension (HTN) are at higher risk for severe complications such as abruptio placentae, cerebrovascular accident, organ failure and disseminated intravascular coagulation. Even women whose blood pressure (BP) was normal throughout pregnancy may experience transient HTN in the early postpartum period, perhaps reflecting a degree of vasomotor instability. There are several caveats to the diagnosis of pre-existing HTN. Women with undiagnosed mild HTN may appear normotensive in early pregnancy because of the normal fall of BP commencing in the first trimester. Hypertensive disorders in pregnancy, particularly gestational HTN with or without proteinuria, may produce changes in the hematologic, renal and hepatic profiles that may adversely affect prognosis and both neonatal and maternal outcomes. Basic laboratory investigations recommended for monitoring patients with HTN in pregnancy.