Which specialist consultations are helpful for the diagnosis and treatment of hypertensive disorders during pregnancy?

Updated: Jun 12, 2018
  • Author: Michael P Carson, MD; Chief Editor: Edward H Springel, MD, FACOG  more...
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Answer

Answer

Most internists do not have extensive exposure to diagnosing and treating medical disorders during pregnancy and therefore feel some discomfort doing so. Women with chronic hypertension in pregnancy should be monitored by an obstetrician. Women with moderate or severe hypertension may benefit from referral to an experienced internist (obstetric medicine specialist), hypertension subspecialist, and/or a specialist in maternal-fetal medicine (perinatologist). The experience of these experts allows them to assess quickly which treatments offer the best risk-benefit ratio. In most situations, the benefit of maximizing maternal well-being with the usual therapies outweighs potential adverse effects on the fetus.

Diagnosis of secondary hypertension during pregnancy can be difficult; an internal medicine consultation may be useful in the care of these women, as well as women with target organ damage due to chronic hypertension and women in whom preeclampsia causes significant organ failure.


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