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I . HYPERTENSIVE DISORDERS
IN PREGNANCY
Review ofLiterature
Elevated blood pressure during pregnancy is a challenging clinical
problem for which the approach to evaluation and treatment differs
substantially from that employed in nonpregnant patients.
First the diagnostic spectrum is broader since in addition to various
forms of chronic hypertension, the patient may have a short-lived
pregnancy specific form of hypertension i.e preeclampsia, The latter
disorder is accompanied by substantially greater maternal and fetal risks
than in uncomplicated essential hypertension. (Barron, 1995).
Pregnancy may induce hypertension in women who are
normotensive before pregnancy and may aggravate hypertension in those
that are hypertensive before pregnancy. The clinical and laboratory
characteristics of hypertension associated with pregnancy are difficult to
differentiate from those ofhypertension independent ofpregnancy.
As consequence, severe pregnancy-induced or pregnancy­
aggravated hypertension is frequently confused with other diseases
processes such as thrombotic thrombocytopenic purpura (TTP), acute
glornerulonephiritis, and chronic essential hypertension occuring during
pregnancy (Arias, 1993).
Preeclampsia is a disorder ofthe second half ofpregnancy, which
regresses after delivery. Its cause is not known but must lie within the
gravid uterus. Hence although preeclampsia is conventionally defined by
hypertension jt is not primarily a hypertensive disease. The raised blood
pressure and other maternal signs by which it recognized are secondary
features, reflections ofan intrauterine problem. (Redman, 1995).
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