Malignant Hypertension and Subsequent Pregnancy

Objectives: To assess the effect of a diagnosis of malignant-phase hypertension upon subsequent pregnancy outcome. Methods: Suitable patients were identified from the computerized Hospital Activity Analysis register. A retrospective case review was carried out on 8 pregnancies which occurred in 5 individuals, each of whom had in the past suffered from malignant-phase hypertension. Results: Six pregnancies resulted in a live birth although 1 of these died in the neonatal period. One pregnancy was terminated and 1 underwent a spontaneous abortion. Obstetric intervention was high; there were 5 caesarean sections and a forceps delivery. One pregnancy was complicated by worsening hypertension and a further 4 by superimposed preeclampsia. Conclusions: A prior diagnosis of malignant hypertension is not a contraindication to pregnancy. However, these individuals appear to be at high risk of superimposed PET and obstetric intervention.