HOW SWEDISH OBSTETRICIANS MANAGE HYPERTENSIVE DISORDERS IN PREGNANCY - A QUESTIONNAIRE STUDY

Objective. To study treatment of hypertension in pregnancy in Sweden a nd compare our results with a similar study published in 1981. Methods . A multiple choice questionnaire was sent to 92 obstetricians through out Sweden and 88% responded. Results. Most Swedish obstetricians woul d treat a woman in the second trimester with blood pressure 140/95 mmH g without antihypertensive medication (83%) in the out-patient clinic (81%). The corresponding figures according to a similar study publishe d in 1981 were 33% and 71% of obstetricians, respectively. Almost all obstetricians (95%) would give antihypertensive treatment if the blood pressure was 170/110 mmHg or more. Betablockers and hydralazine were the most commonly used drugs. Sixteen per cent of obstetricians would use calcium antagonists, drugs not available in the previous study. Tr eatment with diuretics, methyldopa or diazepam in hypertension was rar ely used. Eight per cent of obstetricians would give low-dose aspirin to patients with mild hypertension and 20% to patients with severe hyp ertension. Fourteen per cent of obstetricians would stop all kind of a ntihypertensive medication and frequently observe patients with essent ial hypertension. Conclusion. Antihypertensive therapy and management of hypertensive disorders of pregnancy show a great disparity among Sw edish obstetricians. National strategies might improve the morbidity a nd mortality associated with hypertensive disorders in pregnancy.