A review of hypertensive disorders of pregnancy.

The detection and clinical management of hypertension in pregnant women are complicated by the concern for fetal development and survival as well as for the health of the mother. Preeclampsia describes a common syndrome that occurs in the second half of pregnancy and often manifesting with hypertension and proteinuria. It occurs in up to 10% of all pregnancies. The factors that initiate preeclampsia are unknown and still a subject of intense clinical research by both Obstetricians and Physicians. The blue print for the development of preeclampsia is probably laid down early in pregnancy, and delivery of the fetus and placenta remains the only effective treatment. Severaclinical, biophysical and biochemical tests have been reported in the world literature to predict the development of preeclampsia. Also, numerous reports have described the predictive value of every possible substance that can be measured in maternal blood or urine. However, the presence of microalbuminuria is an important clinical finding in pregnant women. Indeed, urinary albumin excretion when used as a single test has shown that albumin excretion was higher at booking in those that later developed hypertensive disorders of pregnancy than those that did not have the condition. It had a higher sensitivity and poor predictive value. In conclusion, the factors that are responsible for hypertensive disorders of pregnancy remain unknown and treatment is still difficult. The search for an ideal predictive test or tests should therefore be a continuous exercise.