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Qual Saf Health Care 2003;12:244-245
© 2003 BMJ Publishing Group & Institute for Healthcare Improvement


COMMENTARY

Guidelines in rural practice

Management of hypertension in pregnancy in rural areas

M Maresh

Consultant Obstetrician, St Mary’s Hospital for Women and Children, Manchester M13 0JH, UK; michael.maresh@cmmc.nhs.uk


If we are to develop national guidelines, they must encompass all regions of the country and make allowances for rural areas.

Keywords: rural health services; guidelines; hypertension in pregnancy; general practice

The first 150 words of the full text of this article appear below.

Hypertension in pregnancy remains one of the leading causes of maternal deaths with approximately 1 in 100 000 women in the UK dying from complications associated with it.1 In other parts of the world the figure is higher. Maternal and perinatal morbidity is relatively common in the 0.5–1% of women who have severe hypertension, with eclamptic fits occurring in about 1 in 2000 pregnancies.2 However, hypertension in pregnancy is also a common complication with up to 10% of pregnant women having a significant rise in blood pressure in the third trimester. Furthermore, complications may develop rapidly with a minimal rise in blood pressure. Encouraging pregnant women to have as much antenatal care as possible in the community therefore produces challenges for health professionals. They have to be able to predict the small number who may develop severe complications so that they can be appropriately managed to . . . [Full text of this article]







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