Pre-pregnancy evaluation of essential hypertensive women with poor obstetric history

OBJECTIVE: Essential hypertension is linked to increased maternal and perinatal risks. The aim of this study was to assess women with essential hypertension and poor obstetric history before conception to identify co-morbidities and placenta-related risk factors and to examine how preconception evaluation affects future pregnancy outcomes. METHODS: This retrospective cohort study involved women with poor obstetric history, with (n=25) or without (n=243) essential hypertension. Women were evaluated for co-morbidities and metabolic, immunological, inflammatory, and vascular/thrombotic risk factors. Subsequent pregnancies were then assessed for gestational outcomes. RESULTS: Higher levels of co-morbidity were found in the essential hypertension (+) group compared to high-risk controls (68 vs. 39.9%, p=0.013). Essential hypertension (+) women had significantly higher rates of chronic inflammatory diseases (28 vs. 5.8%, p=0.001) and carbohydrate metabolism disorders (44 vs. 10.3%, p<0.001) than in controls. Except for “APGAR<7” (p=0.016), we were unable to show any statistically significant differences between the study and control groups in terms of placenta-related obstetric complications and gestational outcomes in their forthcoming pregnancies due to necessary precautions and timely management of risk factors. CONCLUSION: Chronic inflammatory diseases and carbohydrate metabolism disorders, which are risk factors for both endothelial injury and placenta-related obstetric complications, are more frequently observed in pregnancies with essential hypertension. Preconception counseling is critical in reducing gestational complications.