Assessment of maternal deaths due to chronic hypertension: Lessons to learn – a ‘red flag’ for maternal and fetal complications

Abstract

Hypertension, including chronic hypertension and gestational hypertension, is the most common medical complication in pregnancy. Chronic hypertension is associated with up to 5% of all pregnancies and accounts for a significant number of adverse complications, such as superimposed pre-eclampsia, abruptio placentae, iatrogenic preterm labour, stillbirth, small-for-gestational-age fetus and maternal death. To improve care, women with chronic hypertension should seek professional advice before pregnancy. Antihypertensive agents, which are known to cause fetal abnormalities, should be replaced with drugs safe for use in pregnancy. Alternatively, a safe antihypertensive agent should be offered as soon as pregnancy is confirmed. Furthermore, women with chronic hypertension have a 13 - 40% chance of developing superimposed pre-eclampsia and need to be seen more frequently during the antenatal period, either by a specialist or under their supervision.