Abstract
The study determined the frequency of placental and fetal disorders responsible for hypertension related fetal and neonatal deaths in a prospective study of 53,518 pregnancies. 3.2% of the pregnancies were placed in the hypertension-proteinuria category when one or more maternal diastolic blood pressures were recorded at 85 mm Hg or more with 1+ or greater proteinuria. The perinatal mortality rate for these pregnancies was 37.9/1000 births and 17.2/1000 for normotensive mothers without proteinuria(P<.01) 42% of the excess mortality associated with hypertension and proteinuria was due to large placental infarcts, 15% to placental growth retardation, 13% to abruptio placentae and the remaining 30% to other disorders.
The perinatal mortality rate for pregnancies that were characterized by hypertension without proteinuria was 26.6/1000 births. 35% of their excess mortality was due to large placental infarcts, 15% to premature rupture of the fetal membranes, 12% to placental growth retardation, 4% to abruptio placentae and the remaining 34% to other disorders. Thus, overall about two thirds of the excess perinatal mortality associated with maternal hypertension during pregnancy was due to three disorders, placental infarcts, marked placental growth retardation and abruptio placentae. The study found hypertension related lesions in decidual and uterine arteries that appear responsible for these three disorders.
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Naeye, R. 371 PERINATAL DEATH RELATED TO PREGNANCY HYPERTENSION AND PROTEINURIA. Pediatr Res 12 (Suppl 4), 425 (1978). https://doi.org/10.1203/00006450-197804001-00376
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DOI: https://doi.org/10.1203/00006450-197804001-00376