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Acute Severe Intrapartum Hypertension

The association with severe maternal morbidity

There was a significantly higher risk for severe maternal morbidity among women with acute severe intrapartum hypertension when compared to women without severe hypertension at 15 hospitals. This according to a study of 2,252 women with acute intrapartum hypertension and 93,650 women without severe hypertension that attempted to determine the association between various first-line antihypertensive agents and post-treatment blood pressure. Researchers found:

• Severe maternal morbidity was significantly more frequent in women with severe hypertension (8.8%) compared to the control group (2.3%).

• Several maternal morbidity rates did not increase with increasing severity of blood pressures.

• There was no difference in severe maternal morbidity between women treated (8.6%) vs women not treated (9.5%).

• Significantly lower antihypertensive treatment rates and higher severe maternal morbidity rates were observed in lower delivery volume hospitals.

• 53% of women treated with oral labetalol as first-line medication met the post-treatment goal of non-severe hypertension, significantly less than those treated with intravenous hydralazine, intravenous labetalol, or oral nifedipine (68%, 71%, and 81%, respectively).

Citation: Kilpatrick SJ, Abreo A, Greene N, et al. Severe maternal morbidity in a large cohort of women with acute severe intrapartum hypertension. [Published online ahead of print January 29, 2016]. Am J Obstet Gynecol. doi: http://dx.doi.org/10.1016/j.ajog.2016.01.176.