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Current Hypertension Reports

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01-01-2021 | Hypertension | Preeclampsia (VD Garovic, Section Editor)

Multiple Gestations and Hypertensive Disorders of Pregnancy: What Do We Know?

Authors: Kavita Narang, Linda M. Szymanski

Published in: Current Hypertension Reports | Issue 1/2021

Abstract

Purpose of Review

The occurrence of hypertensive disorders of pregnancy (HDP) including gestational hypertension, chronic hypertension, preeclampsia, and eclampsia is proportional to the number of fetuses: singletons 6.5%, twins 12.7%, and triplets 20.0%. Literature on HDP in multifetal gestation is sparse compared with singletons. We aim to summarize the current evidence on HDP, specifically in twins.

Recent Findings

HDP occurs more frequently, at an earlier gestational age, and can present more severely and atypically in twin pregnancies. HDP in twins carries a higher risk of maternal/fetal morbidity and mortality including renal failure, stroke, cardiac arrest, pulmonary edema, placental abruption, cesarean delivery, fetal growth restriction, and iatrogenic preterm delivery. Low-dose aspirin (60–150 mg) should be initiated in all multifetal pregnancies to reduce the risk of preeclampsia.

Summary

To improve outcomes and reduce inherent risks associated with multiple gestations, twins should be managed as high-risk pregnancies, and different from singletons.

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Title: Multiple Gestations and Hypertensive Disorders of Pregnancy: What Do We Know?
Authors: Kavita Narang
Linda M. Szymanski
Publication date: 01-01-2021
Publisher: Springer US
Keywords: Hypertension
Pre-Eclampsia
Hypertension
Published in: Current Hypertension Reports / Issue 1/2021
Print ISSN: 1522-6417
Electronic ISSN: 1534-3111
DOI: https://doi.org/10.1007/s11906-020-01107-4

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