Risk Grouping of 113 Patients with Hypertensive Disorders During Pregnancy, with Respect to Serum Urate, Proteinuria and Time of Onset of Hypertension

Abstract

In order to describe the outcome of a one-year material of hypertensive pregnancies, a retrospective analysis was made of the patients with respect to time of onset of hypertension, absence/presence of significant proteinuria, and maximum recorded serum urate values less or greater than 350 mumol/l. The material comprised 113 hypertensive patients, 3.7% of 3036 deliveries in 1980. Of these only 87 could be classified as intended. Twenty-two patients lacked information on serum urate values, and the remaining 4 did not fulfil the inclusion criteria. As the type of antihypertensive treatment was almost exclusively restricted to beta 1-selective betablockers, alone or in combination with hydralazine, the type of treatment given was analysed with respect to the classification system applied. From this retrospective study it is evident that most hypertensive patients tend to be older than the average pregnant woman and that they also tend to represent problems arising during recurrent pregnancies. Patients with additive risk factors such as proteinuria and high serum urate values tend to need more vigorous antihypertensive treatment and in that sense seem to be more difficult to treat. In our material, patients with an early rise in high blood pressure and high serum urate values accounted for the entire perinatal mortality of the hypertensive pregnancies. The values of serum urate monitoring and the future detection and monitoring of hypertensive pregnant patients is discussed.