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Geburtshilfe Frauenheilkd 2004; 64(1): 27-32
DOI: 10.1055/s-2003-44694
Editorial

Georg Thieme Verlag Stuttgart · New York

Management of Preeclampsia Remote from Term

Management der Präeklampsie lange vor dem erwarteten Zeitpunkt der GeburtK. H. Coppage 1 , B. M. Sibai 1
  • 1Department of Obstetrics and Gynecology, University of Cincinnati, Ohio, USA
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Publication History

Publication Date:
19 January 2004 (online)

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Introduction

Hypertensive disorders are the most common medical complication of pregnancy, affecting 5 - 10 % of all pregnancies. Approximately 30 % of hypertensive disorders in pregnancy are due to chronic hypertension and 70 % are due to gestational hypertension-preeclampsia. The spectrum of disease ranges from mildly elevated blood pressures with minimal clinical significance to severe hypertension and multi-organ dysfunction. Understanding the disease process and the impact of hypertensive disorders on pregnancy is of the utmost importance, as these disorders remain a major cause of maternal and perinatal morbidity and mortality worldwide. Maternal complications include: abruptio placentae, disseminated intravascular coagulation, eclampsia, renal failure, liver failure or hemorrhage, hypertensive encephalopathy, pulmonary edema, and death. Fetal neonatal complications include: intrauterine growth restriction, preterm delivery, hypoxia/acidosis, neurologic injury, and death.

References

  • 1 Report of the National High Blood Pressure Education Program . Working group report on high blood pressure in pregnancy.  Am J Obstet Gynecol. 2000;  183 S1-S22
    CrossrefPubMedSearch in Google Scholar
  • 2 Diagnosis and Management of Preeclampsia and Eclampsia . ACOG Practice Bulletin No. 33. American College of Obstetricians and Gynecologists.  Obstet Gynecol. 2001;  98 159-167
    PubMedSearch in Google Scholar
  • 3 Buchbinder A, Sibai B M, Caritis S, Macpherson C, Hauth J, Lindheimer M D. Adverse perinatal outcomes are significantly higher in severe gestational hypertension than in mild preeclampsia.  Am J Obstet Gynecol. 2002;  186 66-71
    CrossrefPubMedSearch in Google Scholar
  • 4 Barton J R, O'Brien J M, Bergauer N K, Jacques D L, Sibai B M. Mild gestational hypertension remote from term: progression and outcome.  Am J Obstet Gynecol. 2001;  184 979-983
    CrossrefPubMedSearch in Google Scholar
  • 5 Dekker G A, Sibai B M. Pathogenesis and etiology of preeclampsia.  Am J Obstet Gynecol. 1998;  179 1359
    CrossrefPubMedSearch in Google Scholar
  • 6 Barton J R, Witlin A G, Sibai B M. Management of mild preeclampsia.  Clin Obstet Gynecol. 1999;  42 465-469
    PubMedSearch in Google Scholar
  • 7 Magee L A, Ornstein M P, Von Dadelszen P. Fortnightly review: management of hypertension in pregnancy.  BMJ. 1999;  318 1332-1336
    PubMedSearch in Google Scholar
  • 8 Friedman S A, Lubarsky S, Schiff E. Expectant management of severe preeclampsia remote from term.  Clin Obstet Gynecol. 1999;  42 470-478
    CrossrefPubMedSearch in Google Scholar
  • 9 Amorim M MR, Santas L C, Faundes A. Corticosteroid therapy for prevention of respiratory distress syndrome in severe preeclampsia.  Am J Obstet Gynecol. 1999;  180 1283-1288
    PubMedSearch in Google Scholar
  • 10 Hogg B, Hauth J C, Caritis S N, Sibai B M, Lindheimer M. et al . Safety of labor epidural anesthesia for women with severe hypertensive disease. National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network.  Am J Obstet Gynecol. 1999;  181 1096-1101
    PubMedSearch in Google Scholar
  • 11 Witlin A G, Friedman S A, Sibai B M. The effect of magnesium sulfate therapy on the duration of labor in women with mild preeclampsia at term: a randomized, double-blind, placebo-controlled trial.  Am J Obstet Gynecol. 1997;  176 623-627
    CrossrefPubMedSearch in Google Scholar
  • 12 Duley L, Henderson-Smart D J. Drugs for rapid treatment of very high blood pressure during pregnancy (Cochrane Review).  The Cochrane Library, Issue 2. Oxford; Update Software 2000
    Search in Google Scholar
  • 13 Schiff E, Friedman S A, Sibai B M. Conservative management of severe preeclampsia remote from term.  Obstet Gynecol. 1994;  84 620-630
    PubMedSearch in Google Scholar
  • 14 Sibai B, Hnat M. Delayed delivery in severe preeclampsia remote from term.  OBG management. 2002;  14 92-108
    PubMedSearch in Google Scholar
  • 15 MacKay A P, Berg C J, Atrash H I. Pregnancy related mortality from preeclampsia and eclampsia.  Obstet Gynecol. 2001;  97 533-538
    CrossrefPubMedSearch in Google Scholar
  • 16 Scardo J A, Vermillion S T, Newman R B, Chauhan S P, Hogg B B. A randomized, double-blind, hemodynamic evaluation of nifedipine and labetalol in preeclamptic hypertensive emergencies.  Am J Obstet Gynecol. 1999;  181 862-866
    CrossrefPubMedSearch in Google Scholar
  • 17 Mabie B C, Gonzalez A R, Sibai B M, Amon E. A comparative trial of labetalol and hydralazine in the acute management of severe hypertension complicating pregnancy.  Obstet Gynecol. 1987;  70 328-333
    PubMedSearch in Google Scholar
  • 18 Katz V L, Farmer R, Kuller J A. Preeclampsia into eclampsia: Toward a new paradigm.  Am J Obstet Gynecol. 2000;  182 1389-1396
    CrossrefPubMedSearch in Google Scholar

M. D. B. M. Sibai

Department of Obstetrics and Gynecology · University of Cincinnati, Ohio

231 Albert Sabin Way, M/L 0526

Cincinnati, Ohio 45267-0526

USA

Email: Sibaibm@ucmail.uc.edu