%0 Journal Article
%T Adverse Maternal Consequences Associated with Prolonged Acute-Onset Severe Systolic Hypertension during Pregnancy & Early Postpartum: Pitfalls in Practice & Lessons Learned
%A James Nello Martin Jr.
%A James Martin Tucker
%J Open Journal of Obstetrics and Gynecology
%P 626-635
%@ 2160-8806
%D 2021
%I Scientific Research Publishing
%R 10.4236/ojog.2021.115058
%X <strong>OBJECTIVE:</strong> <span style=\"font-family:Verdana;\"><span style=\"font-family:Verdana;\"><span style=\"font-family:Verdana;\">To determine the types of major maternal-perinatal morbidity associated
with prolonged, acute-onset severe systolic hypertension during pregnancy and
postpartum.</span></span></span><span><span><span style=\"font-family:&quot;\"> </span></span></span><span style=\"font-family:Verdana;\"><span style=\"font-family:Verdana;\"><b><span style=\"font-family:Verdana;\">METHODS: </span></b></span></span><span><span><span style=\"font-family:&quot;\"><span style=\"font-family:Verdana;\">A medicolegal database retaining only medical record data was created
from all cases involving women with medical/hypertensive disorders of pregnancy
evaluated by the first author between 1986-2015. Case files of women that
experienced severe systolic hypertension (SSH) sustained for many hours to days
were identified for study. </span><b><span style=\"font-family:Verdana;\">RESULTS: </span></b><span style=\"font-family:Verdana;\">Sixty six pregnant/postpartum women
met study criteria. Stroke secondary to intracranial hemorrhage or thrombosis
(65.2) and acute pulmonary edema (33%) were the leading causes of maternal
morbidity and mortality, most often antepartum as a component of early-onset
preeclampsia (</span></span></span></span><span><span><span style=\"font-family:&quot;\"><span style=\"font-family:Verdana;\">¡Ü</span><span style=\"font-family:Verdana;\">34 weeks). Eclampsia, abruptio placenta and
injury to heart, liver and/or kidneys were other frequent co-morbidities. Seven
postpartum women developed sudden new-onset postpartum SSH and suffered a
stroke 4</span></span></span></span><span><span><span style=\"font-family:&quot;\"> </span></span></span><span style=\"font-family:Verdana;\"><span style=\"font-family:Verdana;\"><span style=\"font-family:Verdana;\">-</span></span></span><span><span><span style=\"font-family:&quot;\"> </span></span></span><span><span><span style=\"font-family:&quot;\"><span style=\"font-family:Verdana;\">13 days after delivery. Maternal mortality (54.6%) and morbidity as persistent
disability (24.2%) were high in this cohort. </span><b><span style=\"font-family:Verdana;\">CONCLUSION: </span></b><span style=\"font-family:Verdana;\">Failure to
rapidly respond, reduce and sustain at a safe level acute-onset SSH poses a
significant threat to the wellbeing of mothers and babies, before and in the
weeks following delivery. Systems to implement safe practices to identify and
emergently treat severe maternal
%K Severe Systolic Hypertension Acute Pulmonary Edema Maternal Morbidity &amp
%K Mortality Maternal Safety
%U http://www.scirp.org/journal/PaperInformation.aspx?PaperID=109391