A Comprehensive Review of Current Advancements in the Diagnosis, Treatment, and Long-Term Implications of Hypertensive Disorders of Pregnancy

TL;DR

This review summarizes recent advances in diagnosing and managing hypertension during pregnancy and highlights strategies to improve maternal and fetal outcomes.

Contribution

The paper provides a comprehensive overview of current diagnostic tools, treatments, and long-term implications of hypertensive disorders of pregnancy.

Findings

Home blood pressure monitoring is a reliable method for tracking BP during pregnancy.

Biomarkers like sFLT-1/PLGF ratio help diagnose preeclampsia.

Antihypertensive drugs and lifestyle changes reduce adverse outcomes.

Abstract

This narrative review aims to analyze the existing data on the diagnosis, risk factors, treatment, prevention, and long-term implications of hypertension in pregnancy. An extensive search was conducted using the PubMed database to identify relevant studies from the past 10 years. These studies indicate that hypertension during pregnancy is a leading cause of maternal and infant mortality in the United States. Early identification of high-risk individuals, along with improved prenatal screening and early intervention strategies, has been shown to enhance maternal care. Home blood pressure monitoring (HBPM) is a simple and reliable method for measuring an individual's blood pressure (BP). Hypertensive disorders of pregnancy can be predicted using biomarkers such as alpha-fetoprotein, free beta-human chorionic gonadotropin (hCG), and D-dimer in blood samples. Additionally, the soluble fms-like tyrosine kinase 1-to-placental growth factor (sFLT-1/PLGF) ratio is a key biomarker for diagnosing early- and late-onset preeclampsia. The administration of antihypertensive medications for mild-to-moderate hypertension is beneficial in preventing adverse maternal and fetal outcomes. First-line (such as labetalol) and second-line (including nifedipine, methyldopa, and hydrochlorothiazides) drugs are commonly used. Aspirin may be used prophylactically in cases of chronic hypertension to prevent preeclampsia. In addition to this, planned delivery at 38 weeks of gestation has been associated with a reduction in adverse outcomes for both mother and fetus. Regular BP monitoring, smoking cessation, and adherence to a healthy diet and lifestyle can help reduce the long-term complications of hypertension during pregnancy.

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