Skip to main content

Advertisement

SpringerLink
Log in

Hypertension in pregnancy: New recommendations for managemen

  • Published:
Current Hypertension Reports Aims and scope Submit manuscript

Abstract

Hypertension in pregnancy is a frequent complication that has substantial adverse perinatal outcomes. Hypertension may be preexisting (chronic) essential or secondary hypertension; a second entity is pregnancy induced (gestational hypertension, preeclampsia). Recent advances have identified newer markers for pregnancy hypertension: several potential candidate genes may explain the apparent family inheritance of preeclampsia, and some thrombophilic markers hav been associated with the condition. Management options for mild to moderate hypertension include a short hospital stay to exclude ongoing severe hypertension and to ascertain fetal well-being. Outpatient care with appropriate materna and fetal surveillance, including umbilical artery dopple velocimetry, is recommended for better perinatal outcomes. Acute care for severe hypertension includes the use of magnesium sulfate to prevent eclampsia and antihypertensiv medication. Expeditious delivery is recommended when the maternal or fetal states cannot be stabilized. Follow-up after delivery allows the uncovering of any other coexisting hypertensive or cardiovascular disorder.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References and Recommended Reading

  1. National High Blood Pressure Education Program: Working group on high blood pressure in pregnancy. Am J Obstet Gynecol 1990, 163:1689–1712.

    Google Scholar 

  2. Harm K, Rath W, Hertig E, et al.: Maternal hemolysis, elevated liver enzymes, low platelets count and neonatal income. Am J Perinatol 1995, 12:1–6.

    Article  Google Scholar 

  3. Rey E, Couturier A: The prognosis of women with chronic hypertension. Am J Obstet Gynecol 1994, 171:410–416.

    PubMed  CAS  Google Scholar 

  4. Helewa ME, Burrows RF, Smith J, et al.: Report of the Canadian Hypertension Society Consensus Conference: definition, evaluation and classification of hypertensive disorders in pregnancy. Can Med Assoc J 1997, 157:715–725.

    CAS  Google Scholar 

  5. Moutquin JM, Rainville C, Giroux L, et al.: A prospective study of blood pressure in pregnancy: prediction of preeclampsia. Am J Obstet Gynecol 1985, 151:191–196.

    PubMed  CAS  Google Scholar 

  6. Ness RB, Roberts JM: Heterogenous causes constituting the single syndrome of preeclamsia: a hypothesis and its implications. Am J Obstet Gynecol 1996, 175:1366–1370.

    Article  Google Scholar 

  7. Massé J, Forest JC, Moutquin JM, et al.: A prospective study of several potential markers for early detection of development of preeclampsia. Am J Obstet Gynecol 1993, 169:501–508.

    PubMed  Google Scholar 

  8. Pouliot L, Forest JC, Moutquin JM, et al.: Platelet angiotensin II binding sites and early detection of preeclampsia. Obstet Gynecol 1998, 91:591–595.

    Article  PubMed  CAS  Google Scholar 

  9. Endresen MJ, Tosti E, Lorentzen B, et al.: Sera of preeclampsia women are not cytotoxic to endothelial cells in culture. Am J Obstet Gynecol 1995, 172:196–100.

    Article  PubMed  CAS  Google Scholar 

  10. O’Brien TF: Predicting preeclampsia. Obstet Gynecol 1990, 75:445–452.

    PubMed  Google Scholar 

  11. Irion O, Massé J, Forest JC, et al.: Prediction of preeclampsia, low birthweight for gestation and prematurity by uterine artery blood flow velocity waveforms analysis in low risk nulliparas. Br J Obstet Gynaecol 1998, 105:422–429.

    Article  PubMed  CAS  Google Scholar 

  12. Chesley LC, Cooper DW: Genetics of hypertension in pregnancy: possible single gene control of preeclampsia and eclampsia in the descendants of eclamptic women. Br J Obstet Gynaecol 1986, 93:898–906.

    Article  PubMed  CAS  Google Scholar 

  13. Cooper DW, Hill JA, Chesley LC, et al.: Genetic control of susceptibility to eclampsia and miscarriage. Br J Obstet Gynaecol 1988, 95:644–653.

    Article  PubMed  CAS  Google Scholar 

  14. Thornton JG, Macdonald AM: Twin mothers pregnancy hypertension and preeclampsia. Br J Obstet Gynaecol 1999, 106:570–575.

    Article  PubMed  CAS  Google Scholar 

  15. Ward K, Hata A, Jeunemaitre X, et al.: A molecular variant of antiogensinogen associated with preeclampsia. Nature Genetics 1993, 4:59–61.

    Article  PubMed  CAS  Google Scholar 

  16. Arngrimson R, Purandare S, Connor M, et al.: Angiotnesinogen: a candidate gene involved in preeclampsia? Nature Genetics 1993, 4:114–115.

    Article  Google Scholar 

  17. Wilton AN, Kaye JA, Guo G, et al.: Is angiotensinogen a good candidate gene for preeclampsia ? Hypertens Preg 1995, 14:251–260.

    Article  Google Scholar 

  18. Folgero T, Storbakk N, Torbergsen T, et al.: Mutations in mitochondrial transfert ribonucleic acid genes in preeclampsia. Am J Obstet Gynecol 1996, 174:1626–1630.

    Article  PubMed  CAS  Google Scholar 

  19. Humphrey KE, Jarrison GA, Cooper DW, et al.: HLA-G deletion polymorphism and preeclamsia/eclampsia. Br J Obstet Gynaecol 1995, 102:707–710.

    Article  PubMed  CAS  Google Scholar 

  20. Arngrimsson R, Geirsson RT, Cooke A, et al.: Renin gene restrictions fragment length polymorphisms do not show linkage with preeclampsia and eclampsia. Acta Obstet Gynecol Scand 1994, 73:10–13.

    Article  PubMed  CAS  Google Scholar 

  21. Schiff E, Friedman SA, Sibai BM, et al.: Plasma and placental calcitonin gene-related peptide in pregnancies complicated by severe preeclampsia. Am J Obstet Gynecol 1995, 173:1405–409.

    Article  PubMed  CAS  Google Scholar 

  22. Morgan L, Crawshaw S, Bajer PN, et al.: Function and genetic studies of the angiotensin II type 1 receptor in preeclampsia and normotensive pregnant woment. J Hypertens 1997, 15:1389–1396.

    Article  PubMed  CAS  Google Scholar 

  23. Chen G, Wilson R, Wang SH, et al.: Tumor necrosis factor-alpha (TNF-alpha) gene polymorphism and expression in preeclampsia. Clin Exp Immunol 1996, 104:154–159.

    Article  PubMed  CAS  Google Scholar 

  24. Dekker GA, de Vries JIP, Doelitzsch PM, et al.: Underlying disorders associated with severe early-onset preeclampsia. Am J Obstet Gynecol 1995, 173:1042–1048.

    Article  PubMed  CAS  Google Scholar 

  25. Arias F, Romero R, Joist H, et al.: Thrombophilia: a mechanism of disease in women with adverse pregnancy outcome and thrombotic lesions in the placenta. J Mater Fetal Med 1998, 7:277–286.

    CAS  Google Scholar 

  26. Kupferminc MJ, Eldor A, Steinman N, et al.: Increased frequency of genetic thrombophilia in women with complications of pregnancy N Engl J Med 1999, 340:9–13.

    Article  PubMed  CAS  Google Scholar 

  27. Bertina R, Koelman B, Koster T, et al.: Mutation in blood coagulation factor V associated with resistance to activated protein C. Nature 1994, 369:64–67.

    Article  PubMed  CAS  Google Scholar 

  28. Bonnar J, Green R, Norris L: Inherited thrombophilia and pregnancy: the obstetric perspective. Sem Thromb Hemost 1998, 24:49–53.

    Google Scholar 

  29. Dizon-Thownson DS, Nelson LM, Easton K, et al.: The Factor V Leiden mutation may predispose women to severe preeclampsia. Am J Obstet Gynecol 1996, 175:902–925.

    Article  Google Scholar 

  30. Grandone E, Margaglione M, Colaizzo D, et al.: Factor V Leiden, CÆT MTHFR polymorphism and genetic susceptibility to preeclampsia. Thromb Haemost 1997, 77:1052–1054.

    PubMed  CAS  Google Scholar 

  31. Wiener-Megnazi Z, Ben-Shlomo I, Goldberg Y, et al.: Resistance to activated protein C and the Leiden mutation: high prevalence in patients with abruptio placentae. Am J Obstet Gynecol 1998, 179:1565–1567.

    Article  Google Scholar 

  32. Grandone E, Margaglione M, Colaizzo D, et al.: Factor V Leiden is associated with repeated and recurrent fetal loss. Thromb Haemost 1997, 77:822–824.

    PubMed  CAS  Google Scholar 

  33. Ridker PM, Miletich JP, Buring JE, et al.: Factor V Leiden mutation as a risk factor for recurrent pregnancy loss. Ann Intern Med 1998, 128:1000–1003.

    PubMed  CAS  Google Scholar 

  34. Grandone E, Margaglione M, Colaizzo D, et al.: Prethrombotic genetic risk factors and the occurrence of gestational hypertension with or without proteinuria. Thromb Haemost 1990, 81:349–352.

    Google Scholar 

  35. Sohda S, Arinami T, Hamada H, et al.: Methylenetetrahydrofolate reductase polymorphism and preeclampsia. J Med Genet 1997, 34:525–526.

    Article  PubMed  CAS  Google Scholar 

  36. Goddijn-Wessel TA, Wouters MG, van de Molen EF, et al.: Hyperhomocysteinema: a risk factor for placental abruption or infarction. Eur J Obstet Gynecol Reprod Biol 1996, 66:23–29.

    Article  PubMed  CAS  Google Scholar 

  37. Van der Put NM, Steegers-Theunissen RP, Frosst P, et al.: Mutated methylenetetrahydrofolate reductase as a risk factor for spina bifida. Lancet 1995, 346:1070–1071.

    Article  PubMed  Google Scholar 

  38. Powers RW, Evans RW, Majors AK, et al.: Plasma homocysteine concentration is increased in preeclampsia and is associated with evidence of endothelial activation. Am J Obstet Gynecol 1998, 179:1605–1611.

    Article  PubMed  CAS  Google Scholar 

  39. Laivuori H, Kaaja R, Turpeinen U, et al.: Plasma homocysteine levels elevated and inversely related to insulin sensitivity in preeclampsia. Obstet Gynecol 1999, 93:489–493.

    Article  PubMed  CAS  Google Scholar 

  40. Leeda M, Rijozi N, de Vries JIP, et al.: Effects of folic acid and vitamin B6 supplementation on women with hyperhomocysteinemia and a history of preeclampsia or fetal growth restriction. Am J Obstet Gynecol 1998, 170:135–139.

    Article  Google Scholar 

  41. Kahn SR: Severe preeclampsia associated with coinheritance of Factor V Leiden mutation and protein S deficiency. Obstet Gynecol 1998, 91:812–814.

    Article  PubMed  CAS  Google Scholar 

  42. De Vries JI, Dekker GA, Huijgens PC, et al.: Hyperhomocysteinaemia and protein S deficiency in complicated pregnancies. Br J Obstet Gynaecol 1997, 104:1248–1254.

    Article  PubMed  Google Scholar 

  43. Cowchock S: Treatment of antiphospholipid syndrome in pregnancy Lupus 1998, 7:S95-S97.

    Article  PubMed  Google Scholar 

  44. Moutquin JM, Garner PR, Burrows RF, et al.: Report of the Canadian Hypetension Society Consensus Conference 2: nonpharmacologic management and prevention of hypertensive disorders in pregnancy. Can Med Assoc J 1997, 157:907–919.

    CAS  Google Scholar 

  45. Rey E, Le Lorier J, Burgess E, et al.: Report of the Canadian Hypertensive Society Consensus Conference 3: pharmacologic treatment of hypertension disorders in pregnancy Can Med Assoc J 1997, 157:1245–1254.

    CAS  Google Scholar 

  46. Helewa M, Heaman M, Robinson MA, et al.: Community-based home care program for the management of preeclampsia: an alternative Can Med Assoc J 1993, 149:829–834.

    CAS  Google Scholar 

  47. Josten LE, Savik K, Mullet SE, et al.: Bed rest compliance for women with pregnancy problems. Birth 1996, 22:1–12.

    Article  Google Scholar 

  48. Crowther CA, Bouwmeester AM, Ashurst HM: Does admission to hospital for bed rest prevent progression or improve fetal outcome in pregnancy complicated by non-proteinuric hypertension? Br J Obstet Gynaecol 1992, 99:13–18.

    PubMed  CAS  Google Scholar 

  49. Chan FY, Pun TC, Lam C, et al.: Pregnancy screening by uterine artery Doppler velocimetry: which criterion performs best? Obstet Gynecol 1995, 85:596–602.

    Article  PubMed  CAS  Google Scholar 

  50. Mires GJ, Williams FLR, Leslie J, et al.: Assessment of uterine arterial notching as a screening test for adverse pregnancy outcome. Am J Obstet Gynecol 1998, 179:1317–1323.

    Article  PubMed  CAS  Google Scholar 

  51. Van Asselt K, Gudmundsson S, Lindqvist P, et al.: Uterine and umbilical artery velocimetry in pre-eclampsia. Acta Obstet Gynecol Scand 1998, 77:614–619.

    Article  PubMed  Google Scholar 

  52. Wang KG, Chen CP, Yang JM, et al.: Impact of reverse enddiastolic flow velocity in umbilical artery on pregnancy outcome after the 28th gestational week. Acta Obstet Gynecol Scand 1998, 77:527–531.

    Article  PubMed  CAS  Google Scholar 

  53. Omtzigt AMWJ, Reuwer PJHM, Bruinse HW: A randomized controlled trial on the clinical value of umbilical Doppler velocimetry in antenatal care. Am J Obstet Gynecol 1994, 170:625–634.

    PubMed  CAS  Google Scholar 

  54. Nielson JP, Alfirevic Z: Doppler ultrasound for fetal assessment in high-risk pregnancies. In Cochrane Collaborations: Cochrane Database of Systematic Reviews: Pregnancy and Childbirth Module. Oxford:Update Software; 1999, 2.

    Google Scholar 

  55. Collins R, Duley L: Any antihypertensive therapy for pregnancy hypertension. In Cochrane Collaborations: Cochrane Database of Systematic Reviews: Pregnancy and Childbirth Module. Oxford:Update Software; 1995.

    Google Scholar 

  56. Magee LA, Ornstein MP, von Dadelszen P: Fortnightly review: management of hypertension in pregnancy. BMJ 1999, 318:1332–1336. The most recent meta-analysis on various subjects related to hypertension in pregnancy.

    PubMed  CAS  Google Scholar 

  57. Steyn DW, Odendaal HJ: Randomised controlled trial of ketanserin and aspirin in prevention of pre-eclampsia. Lancet 1997, 350:1267–1271.

    Article  PubMed  CAS  Google Scholar 

  58. Gruppo di Studio Ipertensione in Gravidanza: Nifedipine versus expectant management in mild to moderate hypertension in pregnancy Br J Obstet Gynaecol 1998, 105:718–722.

    Article  Google Scholar 

  59. Tamas P, Csermely T, Ertl T, et al.: Calcium dobesilate lowers the blood pressure in mild to moderate midtrimester hypertension: a pilot study. Gynecol Obstet Invest 1999, 47:210–213.

    Article  PubMed  CAS  Google Scholar 

  60. CLASP (Collaborative Low-dose Aspirin Study in Pregnancy) Collaborative Group: A randomized trial of low-dose aspirin for the prevention and treatment of preeclampsia among 9364 pregnant women. Lancet 1994, 343:619–629.

    Article  Google Scholar 

  61. Golding J, on behalf of the Jamaica Low-Dose Aspirin Study Group: A randomized trial of low-dose aspirin for primiparae in pregnancy Br J Obstet Gynaecol 1998, 105:293–299.

    Article  PubMed  CAS  Google Scholar 

  62. Rotchell YE, Cruickshank JK, Phillips GM, et al.: Barbados Low-Dose Aspirin in Pregnancy (BLASP): a randomized trial for the prevention of preeclampsia and its complications. Br J Obstet Gynaecol 1998, 105:286–292.

    Article  PubMed  CAS  Google Scholar 

  63. ECPPA (Estudo Collaborative Para Prevencao da Pre-eclampsia com Aspirina) Collaborative Group: Randomised trial of low-dose aspirin for the prevention of maternal and fetal complications in high risk pregnant women. Br J Obstet Gynaecol 1996, 103:39–47.

    Article  Google Scholar 

  64. Caritis SN, Sibai BM, Hauth J, et al.: Low-dose aspirin therapy for the prevention of preeclampsia in high-risk women. N Engl J Med 1998, 338:701–705.

    Article  PubMed  CAS  Google Scholar 

  65. Dumont A, Flahault A, Beaufils M, et al.: Effect of aspirin in pregnant women is dependent on increase in bleeding time. Am J Obstet Gynecol 1999, 180:135–140.

    Article  PubMed  CAS  Google Scholar 

  66. Bower SJ, Harrington KF, Schuchter K, et al.: Prediction of preeclampsia by abnormal uterine Doppler ultrasound and modification by aspirin. Br J Obstet Gynaecol 1996, 103:625–629.

    Article  PubMed  CAS  Google Scholar 

  67. Belizan JM, Villar J, Gonzalez L, et al.: Calcium supplementation to prevent hypertensive disorders of pregnancy. N Engl J Med 1991, 325:1399–1405.

    Article  PubMed  CAS  Google Scholar 

  68. Levine RJ, Hauth JC, Curet LB, et al.: Trial of calcium to prevent preeclampsia. N Engl J Med 1997, 337:69–76.

    Article  PubMed  CAS  Google Scholar 

  69. Waisman GD, Mayorgoi LM, Camera MI, et al.: Magnesium plus nifedipine: potentiation of hypotensive effect in preeclampsia? Am J Obstet Gynecol 1988, 159:308–309.

    PubMed  CAS  Google Scholar 

  70. Duley L, Henderson-Smart DJ: Drugs for rapid treatment of very high blood pressure during pregnancy. In Cochrane Collaborations: Cochrane Database of Systematic Reviews: Pregnancy and Childbirth Module. Oxford:Update Software; 1999, 3.

    Google Scholar 

  71. Mabie WC, Gonzalez AR, Sibai SM, et al.: A comparative trial of labetalol and hydralazine in the acute management of severe hypertension complicating pregnancy. Obstet Gynecol 1987, 70:328–333.

    PubMed  CAS  Google Scholar 

  72. Matins-Costa S, Ramos JG, Barros E, et al.: Randomized, controlled trial of hydralazine versus nifedipine in preeclamptic women with acute hypertension. Clin Exp Hypertens 1992, 11:25–44.

    Google Scholar 

  73. Bolte AC, van Eyck J, Kanhai HH, et al.: Ketanserin versus dihydralazine in the management of severe early-onset preeclampsia: maternal outcome. Am J Obstet Gynecol 1999, 80(pt 1):371–377.

    Article  Google Scholar 

  74. Wacker J, Werner P, Walter-Sack I, et al.: Treatment of hypertension in patients with pre-eclampsia: a prospective parallel-group study comparing digydralazine with urapidil. Nephrol Dial Transplant 1998, 13:318–325.

    Article  PubMed  CAS  Google Scholar 

  75. Kumar N, Batra YK, Bala I, et al.: Nifedipine attenuates the hypertensive response to tracheal intubation in pregnancyinduced hypertension. Can J Anaesth 1993, 40:329–333.

    Article  PubMed  CAS  Google Scholar 

  76. Ramanathan J, Sibai BM, Mabie WC, et al.: The use of labetalol for attenuation of the hypertensive response to endotracheal intubation in preeclampsia. Am J Obstet Gynecol 1988, 159:650–654.

    PubMed  CAS  Google Scholar 

  77. Ramanathan J, Coleman P, Sibai BM: Anesthetic modification of hemodynamic and neuroendocrine stress responses to cesarean delivery in women with severe preeclampsia. Anesth Analg 1991, 73:772–779.

    PubMed  CAS  Google Scholar 

  78. The Eclampsia Trial Collaborative Group: Which anticonvulsant for women with eclampsia? Evidence from the Collaborative Eclampsia Trial. Lancet 1995, 345:1455–1463.

    Google Scholar 

  79. Coetzee EJ, Dommisse J, Anthony J: A randomised controlled trial of intravenous magnesium sulphate versus placebo in the management of women with severe pre-eclampsia. Br J Obstet Gynaecol 1998, 105:300–303.

    Article  PubMed  CAS  Google Scholar 

  80. Lucas MJ, Leveno KJ, Cunningham FG: A comparison of magnesium sulfate with phenytoin for the prevention of preeclampsia. N Engl J Med 1995, 333:201–205.

    Article  PubMed  CAS  Google Scholar 

  81. Duley L, Gulmezoglu AM, Henderso-Smart DJ: Anticonvulsants for preeclampsia. In Cochrane Collaborations: Cochrane Database of Systematic Reviews: Pregnancy and Childbirth Module. Oxford:Update Software; 1999, 2.

    Google Scholar 

  82. Burrows RF, Burrows EA: The feasibility of a control population for a randomized control trial of seizure prophylaxis in the hypertensive disorders of pregnancy. Am J Obstet Gynecol 1995, 173:929–935.

    Article  PubMed  CAS  Google Scholar 

  83. Clark SL, Cotton DB: Clinical indications for pulmonary artery catheterization in the patient with severe preeclampsia. Am J Obstet Gynecol 1988, 158:453–458.

    PubMed  CAS  Google Scholar 

  84. Clark SL, Greenspoon JS, Aldahl D, et al.: Severe preeclampsia with persistant oliguria: management of hemodynamic subsets. Am J Obstet Gynecol 1986, 154:490–494.

    PubMed  CAS  Google Scholar 

  85. Benedetti TJ, Kates R, Williams V: Hemodynamic observations in severe preeclampsia complicated by pulmonary edema. Am J Obstet Gynecol 1985, 152:330–334.

    PubMed  CAS  Google Scholar 

  86. Belfort MA, Anthony J, Saade GR, et al.: The oxygen consumption/oxygen delivery curve in severe preeclampsia: evidence for a fixed oxygen extraction state. Am J Obstet Gynecol 1993, 169:1448–1455.

    PubMed  CAS  Google Scholar 

  87. Hayes MA, Timmins AC, Yau EHS, et al.: Elevation of systemic oxygen delivery in the treatment of critically ill patients. N Engl J Med 1994, 330:1717–1722.

    Article  PubMed  CAS  Google Scholar 

  88. Gattinoni L, Brazzi L, Pelosi P, et al.: A trial of goal-oriented hemodynamic therapy in critically ill patients. N Engl J Med 1995, 333:1025–1032.

    Article  PubMed  CAS  Google Scholar 

  89. Sibai BM, Mercer BM, Schiff E, et al.: Aggressive versus conservative management of severe preeclampsia at 28 to 32 weeks’ gestation: a randomized controlled trial. Am J Obstet Gynecol 1994, 171:818–822.

    PubMed  CAS  Google Scholar 

  90. Odendaal HJ, Pattinson RC, Bam R, et al.: Aggressive or expectant management for patients with severe preeclampsia between 28–-34 weeks’ gestation: a randomized controlled trial. Obstet Gynecol 1990, 76:1070–1075.

    PubMed  CAS  Google Scholar 

  91. Fenakel K, Fenakel G, Appelman Z, et al.: Nifedipine in the treatment of severe preeclampsia. Obstet Gynecol 1991, 77:331–337.

    PubMed  CAS  Google Scholar 

  92. Schiff E, Friedman SA, Sibai BM: Conservative management of severe preeclampsia remote from term. Obstet Gynecol 1994, 84:626–630.

    PubMed  CAS  Google Scholar 

  93. Schiff E, Friedman SA, Kao L, et al.: The importance of urinary protein excretion during conservative management of severe preeclampsia. Am J Obstet Gynecol 1996, 175:1313–1316.

    Article  PubMed  CAS  Google Scholar 

  94. Chesley SC, Annitto JE, Cosgrove RA: The remote prognosis of eclamptic women: sixth periodic report. Am J Obstet Gynecol 1976, 124:446–459.

    PubMed  CAS  Google Scholar 

  95. Sibai BM, Sarinoglu C, Mercer BM: Eclampsia VII: pregnancy outcome after eclampsia and long-term prognosis. Am J Obstet Gynecol 1992, 166:1757–1763.

    PubMed  CAS  Google Scholar 

  96. Jonsdottir LS, Arngrimsson R, Geirsson RT, et al.: Death rates from ischemic heart disease in women with a history of hypertension in pregnancy Acta Obstet Gynecol Scand 1995, 74:772–776.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Sainte-Justine Hospital, Université de Montréal, Montréal, Canada

    Roberta Shear MD, FRCSC, Line Leduc MD, FRCSC, Evelyne Rey MD, MSc, FRCPC & Jean-Marie Moutquin MD, MSc, FRCSC

Authors
  1. Roberta Shear MD, FRCSC
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Line Leduc MD, FRCSC
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Evelyne Rey MD, MSc, FRCPC
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jean-Marie Moutquin MD, MSc, FRCSC
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Shear, R., Leduc, L., Rey, E. et al. Hypertension in pregnancy: New recommendations for managemen. Curr Hypertens Rep 1, 529–539 (1999). https://doi.org/10.1007/s11906-996-0026-7

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11906-996-0026-7

Keywords

Search

Navigation