Hypertensive disorders in pregnancy
Prabinendra Nath Nobis
Hypertensive disorders in pregnancy are common medical complication of pregnancy. Maternal and perinatal mortality and morbidity associated with these conditions are very high. Pre- eclampsia and eclampsia are variant of these disorders. Aetiology of these disorders is not known. Several theories are postulated. Now it is believed to be an exaggerated response to inflammatory reaction of pregnancy. No single test has so far been identified for prediction. Depending on clinical factors like family history of hypertension, past history of hypertension aspirin in low dose is used to minimize the incidence. In eclampsia magnesium sulphate is the anticonvulsant of choice worldwide. Antihypertensive drugs like methyl dopa, labetalol, and hydralazine are used to lower blood pressure to a safe level. Delivery should be planned at the oportunate time. Factors to be considered for timing of delivery are gestational age, maternal, and fetal conditions. HELLP syndrome is another complication of preeclampsia. Diagnosis and management of HELLP syndrome are reviewed.