Continuing Medical Education

Assessment of maternal deaths due to chronic hypertension: Lessons to learn – a ‘red flag’ for maternal and fetal complications

J Moodley, N C Ngene


Hypertension, including chronic hypertension and gestational hypertension, is the most common medical complication in pregnancy. Chronic hypertension is associated with up to 5% of all pregnancies and accounts for a significant number of adverse complications, such as superimposed pre-eclampsia, abruptio placentae, iatrogenic preterm labour, stillbirth, small-for-gestational-age fetus and maternal death. To improve care, women with chronic hypertension should seek professional advice before pregnancy. Antihypertensive agents, which are known to cause fetal abnormalities, should be replaced with drugs safe for use in pregnancy. Alternatively, a safe antihypertensive agent should be offered as soon as pregnancy is confirmed. Furthermore, women with chronic hypertension have a 13 - 40% chance of developing superimposed pre-eclampsia and need to be seen more frequently during the antenatal period, either by a specialist or under their supervision.

Authors' affiliations

J Moodley, Women’s Health and HIV Research Group, Department of Obstetrics and Gynaecology, School of Clinical Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa

N C Ngene, Department of Obstetrics and Gynaecology, Klerksdorp Hospital, South Africa

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Adverse pregnancy complications; Hypertension; Maternal deaths

Cite this article

South African Medical Journal 2018;108(11):896-900. DOI:10.7196/SAMJ.2018.v108i11.13365

Article History

Date submitted: 2018-10-26
Date published: 2018-10-26

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