Management of hypertension in pregnancy

Abstract

Hypertensive states of pregnancy are a set of disorders that occur during gestation whose common nexus is hypertension. They must be given special emphasis due to their implication in maternal and neonatal morbidity and mortality. A classification is made of the different hypertensive states, with special emphasis placed on preeclampsia. This article defines the symptoms and signs of the disease and a differential diagnosis is made amongst diseases that must be ruled out. It is important to identify expectant mothers with preeclampsia, and it is of even greater importance in such cases to rule out some criterion of seriousness, as this will enable a different management to be carried out. The article includes the indications and the moment when the pregnancy finalises. Similarly, it details the controls that must be made if an expectant management is chosen for the benefit of the premature baby. The different anti-hypertensive therapeutical options are detailed, as well as the prophylactic treatment of eclampsia with magnesium sulphate. Because of their intrinsic interest, we draw special attention to the HELLP syndrome and to eclampsia as complications. The treatment and conduct that must be followed in gestation is described.