Review:The important epidemiology of pre-eclampsia

Abstract

Hypertensive disorders in pregnancy are responsible for significant mortality and morbidity of which pre-eclampsia is the greatest contributor. More than half of these deaths can be avoided by better understanding the important epidemiology of this disease. By intelligent revision of the final causes of hypertensive death, it is evident that there are only two significant contributory causes, namely cerebral haemorrhage and cardio-respiratory failure, usually manifesting in pulmonary oedema. Accurate measurement and appropriate treatment of blood pressure, seizure prevention, early recognition and referral of women in respiratory distress and monitoring of pulmonary capillary wedge pressure are effective interventions aimed at reducing mortality. The belief that morbidity or mortality associated with pre-eclampsia is confined to the reproductive years is no longer legitimate. The long-term risks of cardiovascular disease, stroke, end-stage renal disease and cognitive decline are increased in women having had one or more pregnancies complicated by this disease. These risks need to be appreciated and addressed by health professionals.