Critically ill obstetric patients with hypertensive disorders of pregnancy : room for improvement

Abstract

Hypertensive disorders of pregnancy constitute a global problem. While they are reported to complicate 5 - 10 % of pregnancies, it is considered that the incidence is rising, owing to a number of factors including the increasing occurrence of cardiac and metabolic diseases in the reproductive age group. It is reported that 42 000 women succumb to hypertensive disorders of pregnancy annually. The majority of these deaths occur in low- and middle-income countries, and it is rare to encounter deaths related to hypertensive disorders of pregnancy in well resourced countries. High mortality rates largely relate to a lack of early recognition and/or timely administration of appropriate therapy for preeclampsia and eclampsia. In South Africa (SA), 18% of maternal deaths are attributed to hypertensive disorders of pregnancy, and they comprise the most common direct cause of maternal deaths. The majority of these deaths have been assessed as preventable.