The Influence Of Blood Pressure, The Time Of Urinary Protein Rise, And Early Intervention Measures On The Outcomes Of Pregnant Gestational Hypertension Patients: A Retrospective Analysis Based On The 2019 Acog Classification

Objective: To explore the influence of blood pressure, the time of urinary protein rise, and early intervention on pregnancy outcomes by determining the changes in hemorheology, the coagulation related indexes, and the incidence of pregnancy complications in patients with gestational hypertension. Methods: The clinical data of 260 parturients of singleton pregnancy with hypertension (the research group) were analyzed retrospectively. According to the American Congress of Obstetricians and Gynecologists' (ACOG) 2019 classification of pregnancy hypertension, these parturients were placed in the pregnancy hypertension group (group A), the preeclampsia without severe manifestations group (group B), the preeclampsia with severe manifestations group (group C), the chronic hypertension group (group D), or the chronic hypertension with preeclampsia group (group E). In addition, 260 pregnant women in the third trimester of pregnancy without complications during the same period in The First Affiliated Hospital of Fujian Medical University were selected as the control group. Results: The research group had a higher rate of elderly patients (>35 years old) and overweight patients (>= 24 kg/m(2)) than the control group. Also, the incidences of postpartum thrombosis and postpartum hemorrhage and the proportion of gestational diabetes mellitus and the level of postpartum D-dimer in the research group were all higher than they were in the control group (P<0.05). Among the research groups, the age and body mass indexes (BMI) of group E were markedly higher than they were in the other groups, the fetal growth restriction (FGR) rates of groups C and D were markedly higher than they were in the other groups, and the stillbirth rate of group D was much higher than it was in the other groups (P<0.05). A multivariate logistic regression analysis showed that odds ratios (OR) of early-onset hypertension and early-onset proteinuria (earlier than 32 weeks) were 4.301 and 3.186. In addition, the use of antihypertensive drugs in late pregnancy increased the incidence of FGR (OR=4.297). Conclusion: The postpartum hyper-coagulable state of patients with gestational hypertension is increased, and they are prone to venous thrombosis. The early use of antihypertensive drugs in patients with gestational hypertension can improve neonatal outcomes.