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Review: evidence is sparse and inconclusive for treating and monitoring chronic mild to moderate hypertension in pregnancy

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 QUESTIONS: In pregnant women with mild to moderate chronic hypertension, what is the magnitude of maternal and fetal risks, how effective and safe are treatments before and during pregnancy, and what monitoring strategies are effective for detecting fetal complications associated with the hypertension?

Data sources

Studies were identified by searching 16 electronic databases from their inception to February 1999; scanning bibliographies of textbooks, studies, and reviews; and contacting experts.

Study selection

Study inclusion criteria varied according to the question (eg, randomised controlled trials [RCTs] for treatment and prevention questions and case control and cohort studies for causation and monitoring questions). All included studies evaluated pregnant women with chronic hypertension.

Data extraction

Data were extracted on study design and quality, patient populations, selection and outcome criteria, interventions and comparisons, and outcomes. Analysis used random effects models.

Main results

Few clinical data are available to show the benefits of treating chronic hypertension in non-pregnant young women, although a meta-analysis of 3 RCTs of women aged 30–54 years …

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  • Source of funding: US Agency for Healthcare and Research Quality.

  • For correspondence: Dr C D Mulrow, Audie L Murphy Veterans Hospital, Quality of Life Projects, 7400 Merton Minter Boulevard, (11C-6), San Antonio, TX 78284, USA. Fax +1 210 567 4423.