ABSTRACT
This chapter discusses the effects of chronic hypertension on pregnancy, clarify the terminology and criteria used to define and diagnose it during pregnancy, and review evidence about treatment options. In a meta-analysis of 623 women with mild chronic hypertension from seven trials comparing antihypertensives with no therapy, drug treatment was associated with a decrease in the incidence of severe hypertension but no improvement in perinatal outcomes. Data are inconclusive about the benefits and potential adverse fetal effects from treatment of mild chronic hypertension during pregnancy. A detailed description of the different classes of antihypertensive drugs is presented elsewhere, but experience with their use during pregnancy. While nonpregnant patients with hypertensive crisis most commonly present to emergency care with symptoms related to target-organ involvement, this may be true for pregnant patients, who have many interactions with the health-care system during pregnancy.
