Preconceptional optimization of hypertension
The discussion of optimization of hypertension in pregnancy includes women with pre-existing or chronic hypertension, a history of gestational hypertension, and a history of pre-eclampsia or eclampsia.
Many of the precautions and optimization of these conditions are similar in the preconceptional phase. Women with chronic hypertension are at increased risk for adverse obstetrical outcomes including preterm birth, intrauterine growth restriction, placental abruption, fetal death, and developing pre-eclampsia (30). In the preconception period, optimization of antihypertensive medication and cardiovascular health are the main goals.For women with long-standing chronic hypertension, preconceptional evaluation should include assessment of cardiac and renal involvement, including baseline heart and kidney function tests. Depending on the chronicity and severity of the disease, baseline investigations may include an electrocardiogram, echocardiogram, serum creatinine, glomerular filtration rate, blood
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