Welcoming you for any type of article submission for the upcoming issue on/before February 26, 2021.

Review Article
Volume 7 Issue 9 - 2020
Challenges in Prevention of Hypertensive Disorders of Pregnancy and Their Sequelae
S Chhabra1,2,3*
1Emeritus Professor, Obstetrics Gynecology, Mahatma Gandhi Institute of Medical Sciences, Sevagram, Maharashtra, India
2Officer on Special Duty, Dr. Sushila Nayar Hospital, Utavali, Melghat, Amravati, Maharashtra, India
3Chief Executive Officer, Aakanksha Shishugruha, Kasturba Health Society, Sevagram, Wardha, Maharashtra, India
*Corresponding Author: S Chhabra, Emeritus Professor, Obstetrics Gynecology, Mahatma Gandhi Institute of Medical Sciences, Sevagram, Maharashtra, India.
Received: July 20, 2020; Published: August 14, 2020


Introduction: Globally hypertensive disorders during pregnancy (HDsP), affect around 10% pregnancies, with high chances of dangerous complications, even death during pregnancy birth and postpartum. They also cause fetal growth restriction (FGR), preterm births, low birth weight (LBW) and Perinatal deaths. Attempts need to be made to predict, prevent which presently have limitations.

Objectives: To look into challenges in prevention of HDsP, prevention of complications, mortality in mothers, babies.

Materials and Methods: Studies, reviews were looked into by available search engines to know what is being tried, challenges in prevention of HDsP, severity. Opinions were also looked into. Experiences were added.

Results: Etiology of HDsP is not yet fully understood, though literature indicates up regulation of inflammatory mediators produced by placenta. Many risk factors have been associated but many women do not have any obvious risk factor. Occurrence of HDsP one pregnancy does not predict HDsP in subsequent pregnancy but very preterm gestation at HDsP is associated with higher probability of HDsP in subsequent pregnancy. HDsP associated mortality is much higher in low income settings compared to high income. Quest for biomarkers for prediction continues. Various preventive mortalities are being tried.

Conclusion: Prevention of HDsP remains a great challenge, more so in developing countries with great need of low cost means for prevention. More research useful for global use is needed. Best of management is also a challenge and research needs to continue.

Keywords: Prevention; Hypertensive Disorders during Pregnancy; Challenges


  1. WHO MEM and Count C. “The world health report”. Geneva: World Health Organization (2005).
  2. Tuffnel lD., et al. “Outcomes of severe pre-eclampsia/clampsia in Yorkshire 1999/2003”. BJOG: An International Journal of Obstetrics and Gyaecology7 (2005): 875-880.
  3. Engender Health. “Balancing the Scales: Expanding Treatment for Pregnant Woman with Life-threatening Hypertensive Conditions in Developing Countries. A Report on Barriers and Solutions to Treat Pre-eclampsia and Eclampsia”. New York: Engender Health (2007).
  4. Subramaniam V. “Seasonal variation in the incidence of preeclampsia and eclampsia in tropical elimatic conditions”. BMC Womens Health 7 (2007): 18.
  5. Khan KS., et al. “WHO analysis of causes o maternal death: a systematic review”. Lancet9516 (2006): 1066-1074.
  6. Berhan Y and Berhan A. “Commentary: Actions in the pipeline and the way forward to reduce maternal and perinatal mortality in Ethiopia”. Ethiopian Journal of Health Sciences 24 (2014): 149-168.
  7. Rudra P., et al. “Recent advances in management of pre-eclampsia”. British Journal of Medical Practitioners3 (2011): 14-22.
  8. Delisle H., et al. “Should adolescents be specifically targeted for nutrition in developing countries? To address which problems, and how”. Bulletin of the World Health Organization (2001): 1-26.
  9. Steegers EA., et al. “Pre- eclampsia”. Lancet9741 (2010): 631-644.
  10. Staff AC., et al. “Pregnancy and long-term maternal cardiovascular health: progress through harmonization of research cohorts and biobanks”. Hypertension 67 (2016): 251-260.
  11. Hung JY., et al. “Organization communication, job stress, organizational commitment, and job performance of accounting professionals in Taiwan and America”. Leadership and Organization Development Journal 27 (2006): 242-249.
  12. Sason I and Shamai S. “Performance analysis of linear codes under maximum-likelihood decoding: A tutorial”. Foundations and Trends® in Communications and Information Theory1-2 (2017): 1-222.
  13. Roberts JM and Hubel CA. “The two stage model of preeclampsia: variations on the theme”. Placenta 30 (2009): 32-37.
  14. Lecarpentier E., et al. “Urinary Placental Growth Factor for Prediction of Placental Adverse Outcomes in High-Risk Pregnancies”. Obstetrics and Gynecology6 (2019): 1326-1332.
  15. Sasan SB., et al. “The Effects of Vitamin D Supplement on Prevention of Recurrence of Preeclampsia in Pregnant Women with a History of Preeclampsia”. Obstetrics and Gynecology International (2017): 8249264.
  16. Hofmeyr GJ and Lawrie TA. “Pregnancy for preventing hypertensive disorders and related problems”. The Cochrane Database of Systematic Reviews 6 (2014): CD001059.
  17. Cormick C. “Ultrasound guided therapeutic injections of the cervical spine and brachial plexus”. Australasian Journal of Ultrasound in Medicine 1 (2014): 11-19.
  18. Sibai BM., et al. “Hypertensive pregnancy disorders and subsequent cardiovascular morbidity and type 2 diabetes mellitus in the mother”. Hypertension6 (2009): 944-951.
  19. Hofmeyr GJ., et al. “Prepregnancy and early pregnancy Calcium supplementation among women at high risk of pre-eclampsia: a multicentre, double-blind, randomised, placebo-controlled trial”. The Lancet10169 (2019): 330-339.
  20. Hellmeyer L., et al. “Biochemical markers of bone turnover during pregnancy: a longitudinal study”. Experimental and Clinical Endocrinology and Diabetes09 (2006): 506-510.
  21. Garg S., et al. “Inventors; Siebel Systems Inc, assignee”. Modeling of Order Data (2014).
  22. Singh MC., et al. “The building information modelling trajectory in facilities management: A review”. Automation in Construction 75 (2017): 45-55.
  23. Bujold D., et al. “The epiGenomic Efficient Correlator (epiGeEC) tool allows fast comparison of user datasets with thousands of public epigenomic datasets”. Bioinformatics 4 (2019): 674-676.
  24. Tran NT., et al. “Post-partum family planning in Burkina Faso (Yam Daabo): a two group, multi-intervention, single-blinded, cluster-randomised controlled trial”. The Lancet Global Health8 (2019): e1109-e1117.
  25. Navaratnam K., et al. “Aspirin non-responsiveness in pregnant women at high-risk of pre-eclampsia”. European Journal of Obstetrics and Gynecology and Reproductive Biology 221 (2018): 144-150.
  26. Mone F., et al. “Preeclampsia Prevention Using Routine Versus Screening Test–Indicated Aspirin in Low-Risk Women: A Cost-Effectiveness Analysis”. Hypertension6 (2018): 1391-1396.
  27. Askieet P and Nahamya D. “Assessment of essential drug management in the public health facilities in Uganda”. (Doctoral dissertation, University of Cape Town) (2007).
  28. Villar J., et al. “World Health Organization randomized trial of calcium supplementation among low calcium intake pregnant women”. American Journal of Obstetrics and Gynecology3 (2006): 639-649.
  29. Chen J., et al. “PubChem 2019 update: improved access to chemical data”. Nucleic Acids Research1 (2019): D1102-D1109.
  30. Der Simonian R., et al. “Prostacyclin and thromboxane changes predating clinical onset of preeclampsia: a multicenter prospective study”. The Journal of the American Medical Association 4 (1999): 356-362.
  31. Trumbo PR and Ellwood KC. “Supplemental calcium and risk reduction of hypertension, pregnancy-induced hypertension, and preeclampsia: an evidence-based review by the US Food and Drug Administration”. Nutrition Reviews2 (2007): 78-87.
  32. Xu Y., et al. “Self-assembled graphene hydrogel via a one-step hydrothermal process”. ACS Nano7 (2010): 4324-4330.
  33. Purswani JM., et al. “The role of vitamin D in pre-eclampsia: a systematic review”. BMC Pregnancy Childbirth 1 (2017): 231.
  34. Meher S and Duley L. “Nitric oxide for preventing pre‐eclampsia and its complications”. Cochrane Database of Systematic Reviews 2 (2007): CD00649.
  35. Nahamya D. “Assessment of essential drug management in the public health facilities in Uganda” (2007).
  36. Stephanie Braunthal and Andrei Brateanu. “Hypertension in pregnancy: Pathophysiology and treatment”. SAGE Open Medicine 7 (2019): 2050312119843700.
  37. Hassan SS and Gomez-Lopez N. “Reducing maternal mortality: can elabela help in this fight?” Lancet10192 (2019): 8-9.
  38. Liu Z., et al. “Soluble fms-like tyrosine kinase 1 and soluble endoglin are elevated circulating anti-angiogenic factors in pre-eclampsia”. Pregnancy Hypertension: An International Journal of Women's Cardiovascular Health4 (2012): 358-367.
  39. Abera M “Effect of community level intervention on maternal health care utilization” (Doctoral dissertation (2015).
  40. Bonzini M., et al. “Risk of prematurity, low birthweight and pre-eclampsia in relation to working hours and physical activities: a systematic review”. Occupational and Environmental Medicine4 (2007): 228-243.
  41. Villar J., et al. “World Health Organization randomized trial of calcium supplementation among low calcium intake pregnant women”. American Journal of Obstetrics and Gynecology3 (2006): 639-649.
  42. Miller D. “The generic strategy trap”. Journal of Business Strategy (1992).
  43. Poon LC., et al. “The International Federation of Gynecology and Obstetrics (FIGO) initiative on pre-eclampsia: a pragmatic guide for first-trimester screening and prevention”. International Journal of Gynecology and Obstetrics 145 (219): 1-33.
  44. Duley L. “The global impact of pre-eclampsia and eclampsia”. Seminars in Perinatology3 (2009): 130-137.
  45. Redman CW and Sargent IL, “Staff AC IFPA Senior Award Lecture. Making sense of pre-eclampsia-two placental causes of preeclampsia?”. Placenta 35 (2014): S20-S25.
  46. Rolnik DL., et al. “Aspirin versus placebo in pregnancies at high risk for preterm preeclampsia”. The New England Journal of Medicine 377 (2017): 613-622.
  47. Ziad M., et al. “Protective role of interleukin-10 in atherosclerosis”. Circulation Research8 (2019): e17-e24.
Citation: S Chhabra. “Challenges in Prevention of Hypertensive Disorders of Pregnancy and Their Sequelae”. EC Endocrinology and Metabolic Research 7.9 (2020): 08-15.

PubMed Indexed Article

EC Pharmacology and Toxicology
LC-UV-MS and MS/MS Characterize Glutathione Reactivity with Different Isomers (2,2' and 2,4' vs. 4,4') of Methylene Diphenyl-Diisocyanate.

PMID: 31143884 [PubMed]

PMCID: PMC6536005

EC Pharmacology and Toxicology
Alzheimer's Pathogenesis, Metal-Mediated Redox Stress, and Potential Nanotheranostics.

PMID: 31565701 [PubMed]

PMCID: PMC6764777

EC Neurology
Differences in Rate of Cognitive Decline and Caregiver Burden between Alzheimer's Disease and Vascular Dementia: a Retrospective Study.

PMID: 27747317 [PubMed]

PMCID: PMC5065347

EC Pharmacology and Toxicology
Will Blockchain Technology Transform Healthcare and Biomedical Sciences?

PMID: 31460519 [PubMed]

PMCID: PMC6711478

EC Pharmacology and Toxicology
Is it a Prime Time for AI-powered Virtual Drug Screening?

PMID: 30215059 [PubMed]

PMCID: PMC6133253

EC Psychology and Psychiatry
Analysis of Evidence for the Combination of Pro-dopamine Regulator (KB220PAM) and Naltrexone to Prevent Opioid Use Disorder Relapse.

PMID: 30417173 [PubMed]

PMCID: PMC6226033

EC Anaesthesia
Arrest Under Anesthesia - What was the Culprit? A Case Report.

PMID: 30264037 [PubMed]

PMCID: PMC6155992

EC Orthopaedics
Distraction Implantation. A New Technique in Total Joint Arthroplasty and Direct Skeletal Attachment.

PMID: 30198026 [PubMed]

PMCID: PMC6124505

EC Pulmonology and Respiratory Medicine
Prevalence and factors associated with self-reported chronic obstructive pulmonary disease among adults aged 40-79: the National Health and Nutrition Examination Survey (NHANES) 2007-2012.

PMID: 30294723 [PubMed]

PMCID: PMC6169793

EC Dental Science
Important Dental Fiber-Reinforced Composite Molding Compound Breakthroughs

PMID: 29285526 [PubMed]

PMCID: PMC5743211

EC Microbiology
Prevalence of Intestinal Parasites Among HIV Infected and HIV Uninfected Patients Treated at the 1o De Maio Health Centre in Maputo, Mozambique

PMID: 29911204 [PubMed]

PMCID: PMC5999047

EC Microbiology
Macrophages and the Viral Dissemination Super Highway

PMID: 26949751 [PubMed]

PMCID: PMC4774560

EC Microbiology
The Microbiome, Antibiotics, and Health of the Pediatric Population.

PMID: 27390782 [PubMed]

PMCID: PMC4933318

EC Microbiology
Reactive Oxygen Species in HIV Infection

PMID: 28580453 [PubMed]

PMCID: PMC5450819

EC Microbiology
A Review of the CD4 T Cell Contribution to Lung Infection, Inflammation and Repair with a Focus on Wheeze and Asthma in the Pediatric Population

PMID: 26280024 [PubMed]

PMCID: PMC4533840

EC Neurology
Identifying Key Symptoms Differentiating Myalgic Encephalomyelitis and Chronic Fatigue Syndrome from Multiple Sclerosis

PMID: 28066845 [PubMed]

PMCID: PMC5214344

EC Pharmacology and Toxicology
Paradigm Shift is the Normal State of Pharmacology

PMID: 28936490 [PubMed]

PMCID: PMC5604476

EC Neurology
Examining those Meeting IOM Criteria Versus IOM Plus Fibromyalgia

PMID: 28713879 [PubMed]

PMCID: PMC5510658

EC Neurology
Unilateral Frontosphenoid Craniosynostosis: Case Report and a Review of the Literature

PMID: 28133641 [PubMed]

PMCID: PMC5267489

EC Ophthalmology
OCT-Angiography for Non-Invasive Monitoring of Neuronal and Vascular Structure in Mouse Retina: Implication for Characterization of Retinal Neurovascular Coupling

PMID: 29333536 [PubMed]

PMCID: PMC5766278

EC Neurology
Longer Duration of Downslope Treadmill Walking Induces Depression of H-Reflexes Measured during Standing and Walking.

PMID: 31032493 [PubMed]

PMCID: PMC6483108

EC Microbiology
Onchocerciasis in Mozambique: An Unknown Condition for Health Professionals.

PMID: 30957099 [PubMed]

PMCID: PMC6448571

EC Nutrition
Food Insecurity among Households with and without Podoconiosis in East and West Gojjam, Ethiopia.

PMID: 30101228 [PubMed]

PMCID: PMC6086333

EC Ophthalmology
REVIEW. +2 to +3 D. Reading Glasses to Prevent Myopia.

PMID: 31080964 [PubMed]

PMCID: PMC6508883

EC Gynaecology
Biomechanical Mapping of the Female Pelvic Floor: Uterine Prolapse Versus Normal Conditions.

PMID: 31093608 [PubMed]

PMCID: PMC6513001

EC Dental Science
Fiber-Reinforced Composites: A Breakthrough in Practical Clinical Applications with Advanced Wear Resistance for Dental Materials.

PMID: 31552397 [PubMed]

PMCID: PMC6758937

EC Microbiology
Neurocysticercosis in Child Bearing Women: An Overlooked Condition in Mozambique and a Potentially Missed Diagnosis in Women Presenting with Eclampsia.

PMID: 31681909 [PubMed]

PMCID: PMC6824723

EC Microbiology
Molecular Detection of Leptospira spp. in Rodents Trapped in the Mozambique Island City, Nampula Province, Mozambique.

PMID: 31681910 [PubMed]

PMCID: PMC6824726

EC Neurology
Endoplasmic Reticulum-Mitochondrial Cross-Talk in Neurodegenerative and Eye Diseases.

PMID: 31528859 [PubMed]

PMCID: PMC6746603

EC Psychology and Psychiatry
Can Chronic Consumption of Caffeine by Increasing D2/D3 Receptors Offer Benefit to Carriers of the DRD2 A1 Allele in Cocaine Abuse?

PMID: 31276119 [PubMed]

PMCID: PMC6604646

EC Anaesthesia
Real Time Locating Systems and sustainability of Perioperative Efficiency of Anesthesiologists.

PMID: 31406965 [PubMed]

PMCID: PMC6690616

EC Pharmacology and Toxicology
A Pilot STEM Curriculum Designed to Teach High School Students Concepts in Biochemical Engineering and Pharmacology.

PMID: 31517314 [PubMed]

PMCID: PMC6741290

EC Pharmacology and Toxicology
Toxic Mechanisms Underlying Motor Activity Changes Induced by a Mixture of Lead, Arsenic and Manganese.

PMID: 31633124 [PubMed]

PMCID: PMC6800226

EC Neurology
Research Volunteers' Attitudes Toward Chronic Fatigue Syndrome and Myalgic Encephalomyelitis.

PMID: 29662969 [PubMed]

PMCID: PMC5898812

EC Pharmacology and Toxicology
Hyperbaric Oxygen Therapy for Alzheimer's Disease.

PMID: 30215058 [PubMed]

PMCID: PMC6133268

News and Events

March Issue Release

We always feel pleasure to share our updates with you all. Here, notifying you that we have successfully released the March issue of respective journals and the latest articles can be viewed on the current issue pages.

Submission Deadline for Upcoming Issue

ECronicon delightfully welcomes all the authors around the globe for effective collaboration with an article submission for the upcoming issue of respective journals. Submissions are accepted on/before April 03, 2023.

Certificate of Publication

ECronicon honors with a "Publication Certificate" to the corresponding author by including the names of co-authors as a token of appreciation for publishing the work with our respective journals.

Best Article of the Issue

Editors of respective journals will always be very much interested in electing one Best Article after each issue release. The authors of the selected article will be honored with a "Best Article of the Issue" certificate.

Certifying for Review

ECronicon certifies the Editors for their first review done towards the assigned article of the respective journals.

Latest Articles

The latest articles will be updated immediately on the articles in press page of the respective journals.