Chronic Hypertension in Pregnancy.Am J Obstet Gynecol 2019AJ
Chronic hypertension and associated cardiovascular disease are among the leading causes of maternal and perinatal morbidity and mortality in the United States. Chronic hypertension in pregnancy is associated with a host of adverse outcomes, including preeclampsia, cesarean delivery, cerebrovascular accidents, fetal growth restriction, preterm birth, and maternal and perinatal mortality. There are several key issues related to the diagnosis and management of chronic hypertension in pregnancy where data are limited and further research is needed. These challenges and recent guidelines for the management of chronic hypertension are reviewed. Well-timed pregnancies are of utmost importance to reduce the risks of chronic hypertension and long-acting reversible contraceptive options are preferred. Specifically, blood pressure thresholds for diagnosis and treatment in order to optimize short- and long-term maternal and perinatal outcomes should be prioritized along with interventions to reduce extant racial and ethnic disparities.