Treatment of severe hypertension during pregnancy: we still do not know what the best option is

ABSTRACT

Intracranial hemorrhage and stroke are primary causes of maternal mortality in pregnancies affected by hypertensive disorders. As such antihypertensive therapy plays a crucial role in the management of severe hypertension. However, the target level to achieve the best outcome for both – mother and fetus – is still unclear. Moreover, given the lack of well-designed randomized controlled trials with standardized key outcomes, the current choice of antihypertensive medications depends rather on clinicians’ preference. Furthermore, data on long-term outcomes of offspring is not available. Therefore, there is an urgent need for randomized trials comparing different anti-hypertensive options to address efficacy and safety questions.

KEYWORDS:

• Severe hypertension in pregnancy
• key outcome parameters
• target blood pressure
• pre-eclampsia
• maternal and perinatal morbidity

Authorship Details

BWM, DLR, and DW conceived of the idea for this review paper. RW and DW conducted the search of the literature. DW wrote the initial draft manuscript, with subsequent editing and input from BWM, DLR, FSC, RW, and MR. All authors reviewed and agreed upon the final manuscript prior to submission.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

DW is supported by a grant from the Paracelsus Medical University Salzburg, Austria (PMU Research Fund – PMU FFF Number: L-18/02/006-WET) and by Drs Haackert Foundation, Germany.