Study note
Obstetrics & GynecologyHypertensive Disorders in Pregnancy

Definitive treatment and risk scoring in hypertensive pregnancy

THE CONTEXT
Delivery is the definitive treatment for pre-eclampsia, gestational hypertension and eclampsia. The passage also groups maternal risk factors by gestosis score.

Definitive treatment and duration of pregnancy

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Delivery, or termination of pregnancy, is the definitive treatment for pre-eclampsia, gestational hypertension and eclampsia.
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The aim of ongoing treatment is to continue pregnancy, if possible, until fetal maturity without adversely affecting maternal prognosis.

Risk factors assigned score 1

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Listed factors include maternal age above 35 or below 19 years, maternal anemia, obesity with a body mass index above 30, and primigravidity.
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Other factors include a family history of cardiovascular disease, polycystic ovary syndrome, an interpregnancy interval above 7 years, conception using IVF or ICSI, mean arterial pressure above 85 mm Hg, chronic vascular disease with dyslipidemia, and excessive weight gain during pregnancy.

Risk factors assigned score 2

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Listed factors include maternal hypothyroidism, a family history of pre-eclampsia, gestational diabetes mellitus and obesity with a body mass index above 35 kg/m².
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Multifetal pregnancy and hypertensive disease during a previous pregnancy are also included.

Risk factors assigned score 3

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Listed factors include pregestational diabetes mellitus, chronic hypertension, mental disorders, inherited or acquired thrombophilia, maternal chronic kidney disease and autoimmune disease.
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Pregnancy using ovum donation or surrogacy is also included.
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Women with score 3 require further investigations, monitoring and a decision regarding delivery.
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