Maternal and perinatal effects of hypertension at term

This study sought to determine if selected maternal and fetal outcomes in term singleton pregnancies complicated by hypertension during labor differed from those without this complication. All pregnancies delivered at Parkland Memorial Hospital, Dallas, Texas, during 1986 were ascertained using a computerized database. A total of 11,812 term singleton pregnancies ended in delivery during the study period; 1,392 (12%) were complicated by hypertension. Women with a total of 1,383 of these hypertensive pregnancies presented to the hospital with a live fetus. Hypertension was diagnosed in 984 (19%) of the 5,060 primiparous and 399 (6%) of the 6,752 parous women. Hypertension during labor in term singleton pregnancies is associated with increased maternal risks because of the potential complications associated with interventions necessary for successful management. Moreover, hypertension in such pregnancies also increases the perinatal mortality rate. However, this increased rate results from a higher likelihood that fetal death will occur prior to the patient's presentation to the hospital. The risk of fetal morbidity and mortality appears to be low in the hypertensive woman with a term pregnancy admitted to the hospital with a live fetus.