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Hypertension in Pregnancy: A Comprehensive Update

Jim, Belinda MD; Sharma, Shuchita MD; Kebede, Tewabe MD; Acharya, Anjali MD

doi: 10.1097/CRD.0b013e3181c60ca6
Invited Review Article

Hypertensive disorders of pregnancies remain a central public health concern throughout the world, and are a major cause of maternal mortality in the developing world. Although treatment options have not significantly changed in recent years, insight on the pathogenesis of preeclampsia/eclampsia has been remarkable. With improved animal models of preeclampsia and large-scale human trials, we have embarked upon a new era where angiogenic biomarkers based on mechanism of disease can be designed to assist in early diagnosis and treatment. There is also a growing recognition of how elusive the diagnosis of eclampsia can be, especially in the postpartum period. Proper treatment of these patients depends heavily on the correct diagnosis, especially by the emergency physician. Finally, large epidemiologic studies have revealed that preeclampsia, once thought to be a self-limited entity, now appears to portend real damage to the cardiovascular and other organ systems in the long term. This review will present the latest update on our understanding of the various hypertensive disorders of pregnancies and their treatment options.

From the Renal Division, Department of Medicine, Jacobi Medical Center, Bronx, NY.

Correspondence: Belinda Jim, MD, 1400 Pelham Parkway, Building 1, Room 6E15, Bronx, NY 10461. E-mail:

© 2010 Lippincott Williams & Wilkins, Inc.