MATERNAL AND PERINATAL OUTCOME ASSOCIATED WITH HYPERTENSIVE CRISES OFPREGNANCY

Objective: To review prospectively the maternal and perinatal outcome of hypertensive crises of pregnancy at King Edward Vm Hospital, Durban , South Africa. Methods: Women presenting with a diastolic blood press ure of > 110 mm Hg taken on two occasions after a 4-h period of bed re st and/or symptoms and signs of impending eclampsia or convulsions wer e recruited. Results: One hundred forty-five (145) women with hyperten sive crises were seen in the 30 month period of the study; 84 required immediate delivery. Of the remaining 61, 39 required delivery within 48 h of admission to hospital; reasons included further rises in blood pressure (n = 14), increasing serum urate levels and decreasing plate let counts (n = 3), impending eclampsia (n = 1), pulmonary edema (n = 1), cardiotocographic abnormalities on nonstress tests (n = 9), and sp ontaneous labor (n = ii). The remaining 22 patients gained a mean prol ongation of their pregnancies by 5.8 days; 6 of these patients develop ed abruptio placentae. Conclusions: Patients with severe preeclampsia and viable babies should be delivered sooner, rather than later, if fa cilities for intensive monitoring are not available.