Management Of Hypertensive Disorder In Pregnancy

ObjectiveManagement of hypertensive disorder in pregnancyBackgroundHypertension is the most common medical disorder during pregnancy. Approximately 70 % of women diagnosed with hypertension during pregnancy will have hypertensive disorder in pregnancy The term hypertensive disorder in pregnancy is used to describe a wide spectrum of patients who may have only mild elevation in blood pressure (BP) or severely hypertension with various organ dysfunctions including severely preeclampsia; eclampsia; and hemolysis, elevated liver enzymes, low platelets (HELLP) syndrome. The exact incidence of preeclampsia in the Estimates range from 6% to 8% of all pregnancies. Here we shall on the discussion of hypertensive disorder in pregnancy Methods and materialsThe literature search in the management of hypertensive disorder in pregnancy it Was conducted using the medline and Cochrane databases. cross references list of the major article on the subject were used from the year mostly from 2002-2007and few from before 2002 a result was taken by screening the abstracts, reading a full text of the related article including a case control studies, retrospective and prospective cohort studies, and summaraizhd outcome hypothesized on the management of hypertensive disorder in pregnancyResultHypertensive disorder in pregnancy are common disorders during pregnancy, with the majority of cases developing at or near term. The development of mild hypertension or preeclampsia at or near term is associated with minimal maternal and neonatal morbidities. In contrast, the severely early-onset preeclampsia and or severely preeclampsia before 34 weeks' gestation is associated with significant maternal and perinatal complications. Women diagnosed with severely early-onset preeclampsia require close evaluation of maternal and fetal conditions for the duration of pregnancy, and those with severe disease should be managed in-hospital. The decision between delivery and expectant management depends on fetal gestational age, fetal status, and severity of maternal condition at time of evaluation. Expectant management is possible in a select group of women with severely preeclampsia before 34 weeks' gestation. Steroids are effective in reducing neonatal mortality and morbidity when administered to those with severe disease between 24 and 34 weeks' gestation. Magnesium sulfate should be used during labor and for at least 24 hours postpartum to prevent seizures in all women with severe disease. There is an urgent need to conduct randomized trials to determine the efficacy and safety of antihypertensive drugs in women with mild hypertension-preeclampsia. There is also a needed to conduct a randomized trial to determine the benefits and risks of magnesium sulfate during labor and postpartum women with mild preeclampsia. ConclusionThe etiology and pathogenesis of hypertensive disorder in pregnancy remain unknown. Despite all the recent research efforts, there are no reliable tests to predict the development of preeclampsia and there are no effective therapeutic methods to prevent preeclampsia. As a result, expectant management in hypertensive disorder in pregnancy remain a major obstetric problem, accounting for a large percentage of maternal and perinatal morbidities. At present, there are few, if any, multicenter randomized studies available to evaluate the safety and efficacy of the various fetal evaluation techniques or of the various antihypertensive drugs recommended during the management of severely early-onset preeclampsia. There is solid evidence to treat severely hypertension and to use magnesium sulfate as a prophylaxis against convulsions. However, there are inadequate data to support the use of magnesium sulfate in women with mild gestational hypertension o mild preeclampsia. Therefore, until multicenter trials are performed in this area, management of women with preeclampsia will continue to be based on consensus and expert opinion.