Comparison of the course and outcomes of pregnancies complicated by hypertensive disorders

Objective: To compare the course of pregnancy, childbirth, and pregnancy outcomes in patients with hypertensive disorders. Materials and methods: A retrospective study enrolled 335 pregnant women, who were divided into 6 groups. Group 1 included uncomplicated pregnancies (control group, n=60), Group 2 included patients with gestational arterial hypertension (GAH, n=55), Group 3 included patients with chronic arterial hypertension (CAH, n=60), Group 4 included patients with moderate preeclampsia (MPE, n=60), Group 5 included patients with severe preeclampsia (SPE, n=50), Group 6 included patients with preeclampsia superimposed on chronic arterial hypertension (PE/CAH, n=50). Results: Pregnant women with hypertensive disorders were older and had a higher body weight than women in the control group. Women with SPE and PE/CAH were more likely to have a history of PE. The highest rate of edema was observed in the MPE group. Compared to the GAH and CAH groups, uterine-placental and fetal-placental blood flow disorders were significantly more often diagnosed in patients with PE. Pregnancies with SPE were more often complicated by fetal growth restriction and HELLP syndrome. The highest preterm birth was observed in the SPE (52%) and PE/CAH (44%) groups. Most low-birthweight deliveries and neonatal complications occurred in the SPE and PE/CAH groups. Conclusion: The most adverse maternal and perinatal outcomes were observed in the early-onset hypertensive disorders, especially in patients with SPE and PE/CAH. Particular attention should be paid to women with CAH, who constitute the basis of the PE/CAH group and have a high rate of operative delivery.

pregnancy, hypertensive disorders, preeclampsia, perinatal outcomes