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Chapter 38 - Chronic Hypertension and Preeclampsia/HELLP Complications of Pregnancy

from Section 6 - Cardiopulmonary Conditions in Pregnancy

Published online by Cambridge University Press:  23 February 2023

By
Amira El-Messidi ,
Isabelle Malhamé ,
Genevieve Eastabrook  and
Stella S. Daskalopoulou
Edited by
Amira El-Messidi  and
Alan D. Cameron
Amira El-Messidi
Affiliation:
McGill University, Montréal
Alan D. Cameron
Affiliation:
University of Glasgow
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Summary

A 35-year-old G2P1 with chronic hypertension is referred by her primary care provider to your tertiary-care center for prenatal care of a singleton intrauterine pregnancy at 8+2 weeks’ gestation by dating sonography. The patient has no obstetric complaints to date. Her last pregnancy was 10 years ago.

Keywords

Chronic hypertension, pregnancySuperimposed preeclampsiaCounselingRisk factorsInvestigationssoluble fms-like tyrosine kinase-1 (sFlt-1), placental growth factorUterine artery Doppler velocimetryPlacenta, sonographyPerinatal risksLow-dose aspirinCalcium supplementationLong-term maternal-fetal health risksAntihypertensive treatment, intravenous, oralHypertensive crisisMagnesium sulfate, prophylaxis, eclampsiaMagnesium toxicity, treatmentFetal pulmonary corticosteroidsAntenatal, intrapartum, postpartum managementLabor analgesia, thrombocytopeniaContraception
Type
Chapter
Information
OSCEs in Obstetrics and Maternal-Fetal Medicine
An Evidence-Based Approach
 , pp. 488 - 506
Publisher: Cambridge University Press
Print publication year: 2023

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References

Suggested Readings

ACOG Committee Opinion No. 767. Emergent therapy for acute-onset, severe hypertension during pregnancy and the postpartum period. Obstet Gynecol. 2019;133(2):e174–e180.Google Scholar
American College of Obstetricians and Gynecologists' Committee on Practice Bulletins – Obstetrics. ACOG Practice Bulletin No. 209: Obstetric analgesia and anesthesia. Obstet Gynecol. 2019;133(3):e208–e225.CrossRefGoogle Scholar
Brown, MA, Magee, LA, Kenny, LC, et al. The hypertensive disorders of pregnancy: ISSHP classification, diagnosis and management recommendations for international practice. Pregnancy Hypertens. 2018;13:291–310.CrossRefGoogle ScholarPubMed
Combs, CA, Montgomery, DM. Society for Maternal-Fetal Medicine (SMFM) Special Statement: Checklists for preeclampsia risk-factor screening to guide recommendations for prophylactic low-dose aspirin. Am J Obstet Gynecol. 2020 Sept;223(3):B7–B11.CrossRefGoogle Scholar
Gestational hypertension and preeclampsia: ACOG Practice Bulletin No. 222. Obstet Gynecol. 2020;135(6):e237–e260.CrossRefGoogle Scholar
Lauder, J, Sciscione, A, Biggio, J, et al. Society for Maternal-Fetal Medicine Consult Series No. 50: The role of activity restriction in obstetric management: Am J Obstet Gynecol. 2020;223(2):B2–B10.CrossRefGoogle Scholar
Magee, LA, Pels, A, Helewa, M, et al. Diagnosis, evaluation, and management of the hypertensive disorders of pregnancy: executive summary. J Obstet Gynaecol Can. 2014;36(5):416–441.CrossRefGoogle ScholarPubMed
National Institute for Health and Care Excellence (NICE). Hypertension in pregnancy: diagnosis and management (NICE guideline NG133). 2019. Available at www.nice.org.uk/guidance/ng133. Accessed September 10, 2020.Google Scholar
Poon, LC, Shennan, A, Hyett, JA, et al. The International Federation of Gynecology and Obstetrics (FIGO) initiative on pre-eclampsia: A pragmatic guide for first-trimester screening and prevention. Int J Gynaecol Obstet. 2019;145(Suppl 1):1–33. [Correction in Int J Gynaecol Obstet. 2019 Sep;146(3):390–391]CrossRefGoogle ScholarPubMed
Rabi, DM, McBrien, KA, Sapir-Pichhadze, R, et al. Hypertension Canada's 2020 comprehensive guidelines for the prevention, diagnosis, risk assessment, and treatment of hypertension in adults and children. Can J Cardiol. 2020;36(5):596–624.CrossRefGoogle ScholarPubMed
Sotiriadis, A, Hernandez-Andrade, E, da Silva Costa, F, et al. ISUOG Practice Guidelines: role of ultrasound in screening for and follow-up of pre-eclampsia. Ultrasound Obstet Gynecol. 2019;53(1):7–22.CrossRefGoogle ScholarPubMed

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