Document Detail


Differentiating between gestational and chronic hypertension; an explorative study.
MedLine Citation:
PMID:  23237537     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVE: Guidelines define hypertension diagnosed before 20 weeks gestation as chronic hypertension (CH) and thereafter as gestational hypertension (GH). We tested the hypothesis whether hypertension diagnosed before 20 weeks is preceded by CH and if pregnancy outcome depends on the time of onset of hypertension. DESIGN: Retrospective cohort study. SETTING: Tertiary obstetric centre. POPULATION: Women with a history of obstetric vascular complications. METHODS: Blood pressure data prior to and during pregnancy and subsequent maternal and neonatal outcome were reviewed in 148 women. Women were grouped according to the onset of hypertension; pre-pregnancy (CH), before 20 weeks (early GH), after 20 weeks gestation (late GH) and normotensive. MAIN OUTCOME MEASURES: Onset of hypertension, obstetric complications (pre-eclampsia, HELLP (hemolysis, elevated liver enzymes and low platelets) syndrome, intra uterine growth restriction). RESULTS: Twenty nine women had CH. Early GH occurred in 46 women and another 32 developed late GH. Of 75 women with hypertension in the first half of pregnancy 29 (39%) had CH and 46 (61%) early GH. Obstetric complications occurred more often among all hypertensive women, but no differences between the CH and GH groups could be detected. CONCLUSIONS: Hypertension detected in the first half of pregnancy does not necessarily indicate chronic hypertension. Hypertension in general is related to hypertensive maternal complications and fetal growth restriction. Differentiating between chronic or gestational hypertension does not seem to help in establishing the risk for later hypertensive sequelae or intra uterine growth restriction. © 2012 The Authors Acta Obstetricia et Gynecologica Scandinavica © 2012 Nordic Federation of Societies of Obstetrics and Gynecology.
Authors:
Josien A Terwisscha Van Scheltinga; Ineke Krabbendam; Marc E A Spaanderman
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-12-12
Journal Detail:
Title:  Acta obstetricia et gynecologica Scandinavica     Volume:  -     ISSN:  1600-0412     ISO Abbreviation:  Acta Obstet Gynecol Scand     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-12-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370343     Medline TA:  Acta Obstet Gynecol Scand     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2012 The Authors Acta Obstetricia et Gynecologica Scandinavica © 2012 Nordic Federation of Societies of Obstetrics and Gynecology.
Affiliation:
Department of Obstetrics and Gynecology, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands.
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