Hypertension in pregnancy.

Hypertensive diseases of pregnancy are clinically important because they can adversely influence the health and life of both mother and baby. Hypertensive disease is the commonest cause of maternal mortality in England and Wales, accounting for 20.4% of maternal deaths. It is depressing to note that most, if not all, of these deaths are preventable. Three broadly different kinds of hypertension can be identified as potential complications of pregnancy: chronic hypertension, pregnancy-induced hypertension (PIH) and pre-eclampsia. Where chronic hypertension is treated with methyldopa and PIH is treated with atenolol, there is evidence that therapy is beneficial in terms of immediate pregnancy outcome and is not harmful to the child. Atenolol is currently being evaluated in combination with nifedipine to treat cases of early onset of severe pre-eclampsia, and preliminary results are encouraging. Prevention rather than cure should be the aim in managing hypertensive diseases during pregnancy. Early intervention can prevent serious problems later on.