Hypertension artérielle préexistante et grossesse

Hypertension during pregnancy induces a risk of preeclampsia and uterine growth retardation. Hypertension is defined as several blood pressure values higher or equal to 140/90 mmHg at rest. Chronic hypertension preexists to pregnancy or may be diagnosed in the first weeks of pregnancy. It lasts during more than 3 months after delivery. The diagnosis of hypertension during pregnancy should be performed on ambulatory measurements; threshold values are lower in these settings. Chronic hypertension induces a risk of preeclampsia with associated complications. Hypertensive women who are willing to be pregnant need a check-up for hypertension in order to find a treatable cause. This checking should also evaluate the complications of hypertension. The treatment of hypertension decreases the risk of stroke but not the one of preeclampsia nor the small size for gestational age. When the patient is treated for hypertension it is necessary to stop angiotensin-renin system antagonists and most of the diuretics. Gestational age need to be precisely determined in regards of the risk of small size for gestational age. It is critical to check repeatedly the occurrence of preeclampsia especially during the last trimester. Interruption of pregnancy is necessary in most cases of severe complication.