Maternal and Perinatal Outcome Associated with Hypertensive Crises of Pregnancy

Abstract

Objective: To review prospectively the maternal and perinatal outcome of hypertensive crises of pregnancy at King Edward VIII Hospital, Durban, South Africa.

Methods: Women presenting with a diastolic blood pressure of > 110 mm Hg taken on two occasions after a 4-h period of bed rest and/or symptoms and signs of impending eclampsia or convulsions were recruited.

Results: One hundred forty-five (145) women with hypertensive crises were seen in the 30 month period of the study; 84 required immediate delivery. Of the remaining 61, 39 required delivery within 48 h of admission to hospital; reasons included further rises in blood pressure (n = 14), increasing serum urate levels and decreasing platelet counts (n = 3), impending eclampsia (n = 1), pulmonary edema (n = 1), cardiotocographic abnormalities on nonstress tests (n = 9), and spontaneous labor (n = 11). The remaining 22 patients gained a mean prolongation of their pregnancies by 5.8 days; 6 of these patients developed abruptio placentae.

Conclusions: Patients with severe preeclampsia and viable babies should be delivered sooner, rather than later, if facilities for intensive monitoring are not available.

Key Words:

• Maternal and perinatal outcome
• Hypertensive crises of pregnancy