Clinics in perinatology
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When mean arterial pressure exceeds 140 mmHg (equivalent to 180/120), there is a significant risk of maternal cerebral vascular damage. Therefore it is recommended that blood pressures greater than 170/110 should be treated with urgency, aiming to maintain the blood pressure at all times at less than 170/110 but not lower than 130/90. Parenteral hydralazine is effective and safe therapy. ⋯ There seems, therefore, to be no definite indication for treatment of mild hypertension in pregnancy; treatment of moderate hypertension may be reasonable but its value is unproved at present. Antihypertensive drugs are valuable in pregnancy to reduce the risks directly due to elevated blood pressure. These drugs are not expected to affect the evolution of preeclampsia nor to treat the other complications of this condition.
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The maternal cardiovascular system undergoes extensive changes during pregnancy. These changes become especially important in women with underlying cardiac disease. In order to provide a basis for understanding cardiac disease in pregnancy, the authors provide a discussion of the normal cardiovascular physiology of pregnancy, followed by a review of the types of heart disease in women of childbearing age.