Hypertensive disorders during pregnancy

Hypertensive disorders complicate 10 to 20 % of pregnancies and are a leading cause of maternal and perinatal morbidity and mortality. The four major hypertensive disorders in pregnancy are: Preeclampsia - eclampsia, gestational hypertension, chronic hypertension and preeclampsia superimposed on chronic hypertension. Diagnoses may change over time: a patient with gestational hypertension may develop a new onset proteinuria and be considered preeclamptic, or have persistent blood pressure elevation postpartum and be considered as chronically hypertensive. Women who are overweight experience an increased risk of hypertensive disorders. The worldwide increase in obesity will likely result in considerable increase in the occurrence of hypertensive disorders in pregnancy, given the strength and consistency of the association between these two phenomena. This chapter focuses on the four major hypertensive disorders, their significance, related risks and the most widely accepted management options.