Risk factors, prevention and treatment of hypertension in pregnancy.

Hypertensive diseases in pregnancy are common and are associated with significant maternal and perinatal mortality and morbidity. Risk factors for pre-eclampsia include socio-demographical factors (extremes of reproductive age, socio-economic status, ethnic group), genetic factors, pregnancy factors (multiple pregnancies, primigravidae, previous pre-eclampsia) or personal medical history (obesity, chronic renal disease, chronic hypertension, diabetes mellitus, thrombophilia). These risk factors and Doppler screening can help target interventions such as aspirin and calcium that have been proven to reduce the incidence of pre-eclampsia in high risk women. Expectant management is the mainstay of treatment for pre-eclampsia. Hypertension should be controlled by oral or intravenous antihypertensive agents as necessary. Magnesium sulphate is the agent of choice for both the treatment and prevention of eclampsia. Fluid balance and thromboprophylaxis are also both important elements in the management of severe pre-eclampsia.