Williams Manual of Pregnancy Complications by Bloom Steven & Leveno Kenneth & Cunningham F

Author:Bloom, Steven & Leveno, Kenneth & Cunningham, F. [Bloom, Steven]
Language: eng
Format: epub
Publisher: McGraw-Hill
Published: 2012-09-28T00:00:00+00:00

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For further reading in Williams Obstetrics, 23rd ed.,

see Chapter 42, “Critical Care and Trauma.”

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CHAPTER 47

Chronic Hypertension

A diagnosis of chronic hypertension complicating pregnancy is made whenever hypertension precedes pregnancy or occurs prior to 20 weeks’ gestation. Shown in Table 47-1 are blood pressure thresholds for diagnosis of hypertension in adults. In most women with chronic hypertension, increased blood pressure is the only finding. Some women have preexisting complications that put the pregnancy at risk, including hypertensive or ischemic cardiac disease, renal insufficiency, or prior stroke. Predisposing factors for chronic hypertension include obesity and heredity. Women with chronic hypertension are at considerably increased risk for superimposed preeclampsia, which, in turn, substantially increases risks for preterm delivery and other pregnancy complications such as abruptio placentae and fetal growth restriction.

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