User:Mr. Ibrahem/High blood pressure in pregnancy

High blood pressure in pregnancy, also known as hypertensive disorders of pregnancy (HDP), is a group of conditions that result in high blood pressure during pregnancy. Symptoms may vary from none, to headaches, vision changes, shortness of breath, and seizures. Complications for the mother may include stroke, peripartum cardiomyopathy, and spontaneous coronary artery dissection. There is also a risk of diabetes and heart disease in the future. Complications for the baby may include preterm, small for gestational age, and still birth.

Risk factors include older age and obesity. Diagnosis is generally based on a blood pressure greater than 140/90 mmHg at least 4 hours apart, with severe disease being greater than 160/110 mmHg. Types include chronic hypertension, gestational hypertension, preeclampsia/eclampsia, and preeclampsia superimposed on chronic hypertension. White coat hypertension (high blood pressure at health facility, but normal at home) and masked hypertension (normal at health facility, but high at home) may be included as types.

Prevention may include diet, weight loss, and exercise. Low dose aspirin decreases risk when started mid pregnancy. When to begin treatment varies in guidelines from blood pressures over 135/85 to 160/110 mmHg. Medications may include labetalol, nifedipine, methyldopa, or hydralazine with the goal of a blood pressure of 130/80 mmHg. Additionally magnesium sulfate may be used for pre-eclampsia. Early deliver is also recommended.

High blood pressure in pregnancy occurred in about 18 million women in 2019 (7.5% of pregnancies). Though 15% of women are affected at some point in time. It occurs most commonly in Africa, Southeast Asia, and the Middle East. They resulted in 27,800 maternal deaths in 2019 down from 37,000 deaths in 1990. They are the most common cause of death in pregnancy globally (16%) followed by post partum bleeding (13%) and puerperal infections (2%).