Study recommends induced births for women with high blood pressure

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Study recommends induced births for women with high blood pressure and mild pre-eclampsia
04/08/2009

A study from the Netherlands suggests that pregnant women with high blood pressure or mild pre-eclampsia should have an induced birth after 37 weeks to avoid further complications such as eclampsia, HELLP syndrome or maternal death.

Roughly 6-8% of pregnant women in the UK have high blood pressure or high blood pressure problems such as pre-eclampsia.

The HYPITAT study looked at 756 pregnant women who were 36-41 weeks into their pregnancies in the Netherlands who had either high blood pressure or mild pre-eclampsia. The women were then either given an induced labour after 37 weeks or were not given a medical intervention (but followed closely in case treatment was needed).

  • Of the pregnant women who were induced, 31% developed further medical problems
  • Of the expectant mums who were not induced, 44% developed further medical problems.

This means that being induced at 37 weeks seems to reduce the risk of further complications by 29% for pregnant women who have either high blood pressure or mild pre-eclampsia. (No women or babies in either group died during the study.)

Also, fewer pregnant women in the induced group needed a caesarian section when compared with the "no intervention" group.

The study's authors have recommended that women who have high blood pressure (and a diastolic pressure of 95mmHg or higher) or mild pre-eclampsia during their pregnancies should be advised to have their labour induced after 37 weeks.

However, these findings have provoked discussion among health professionals involved in managing and delivering pregnancies. Both the Royal College of Obstetricians and Gynaecologists and the Royal College of Midwives have stated that they see this research as helping to add to the knowledge and choices of expectant mothers and that health professionals should always take into account the needs and wishes of individual expectant mothers when making treatment decisions.


Reference:

The HYPITAT study group. Induction of labour versus expectant monitoring for gestational hypertension or mild pre-eclampsia after 36 weeks' gestation (HYPITAT): a multicentre, open-label randomised controlled trial. The Lancet, Early Online Publication, 4 August 2009   doi:10.1016/S0140-6736(09)60736-4


Topics: Research, High blood pressure


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