Hypertension in pregnancy - Chronic hypertension

5.Chronic hypertension:
Diagnosis is made when :
-Hypertension, blood pressure 140 / 90 mm of hg or greater is documented antecedent to pregnancy.
-Hypertension , blood pressure 140 /90 mm of hg is detected before 20 wks, unless there is gestational trophoblastic disease.
-Hypertension persists long after delivery.

Supporting factors for diagnosis:
- Multiparty
-Hypertension complicating a previous pregnancy other than the first.
-Family history of essential hypertension.

Underlying causes of chronic hypertension disorders:
-Essential familial hypertension (hypertensive vascular disease) in more than 90 %.
-Obesity.
-Arterial abnormalities: ◇Renovascular hypertension ◇Coarctation of the aorta.
-Endocrine disorders:
◇Diabetes mellitus
◇Cushing syndrome
◇Primary aldosteronism ◇Pheochromocytoma ◇Thyrotoxicosis
-Renoprival hypertension:
◇Glomerulonephritis acute and chronic.
◇Chronic glomerulonephritis ◇Chronic renal insuffcieny
◇Diabetic nephropathy
◇Acute renal failure.
-Connective tissue diseases:
◇Lupus erythematosus
◇Systemic sclerosis
◇Periarteritis nodosa
◇Poly cystic kidney disease.

 Evidence of end organ damage from chronic hypertension help in elucidating the underlying cause. Superimposed preeclampsia develops earlier than preeclapmsia.


-Hypertension in pregnancy-classification
-Hypertension in pregnancy-gestational hypertension
-Preeclampsia
-Eclampsia, preeclamsia superimposed on chronic hypertension
-Chronic hypertension
-Hypertension in pregnancy-etiology and pathogenesis
-Pathology
-Mild hypertension in pregnancy-prevention and management
-Severe hypertension in pregnancy-management
-Severe preeclampsia in pregnancy-management
-Complications of hypertension
-Antihypertensive therapy- centrally acting drugs
-Antihypertensive therapy-beta blockers, calcium channel blockers
-Antihypertensive therapy-alpha blockers, vasodilator, diuretics, ACE inhibitors
-Acute severe hypertension - treatment
-Eclampsia - signs and symptoms
-Eclampsia - management