Over the 1990s, but increased by 67% from

Overthe past two decades, the rate of maternal chronic hypertension has nearlydoubled in the United States. The rate of maternal chronic hypertensionincreased only by 16% during the 1990s, but increased by 67% from 2000 to 2009,largely secondary to the obesity epidemic and the increase in maternal age.Rates of chronic hypertension have increased for all racial and Hispanicethnicity groups, with the largest increase among non-Hispanic black women (by87%) and lowest among Asian Pacific Islanders. The 2011 National VitalStatistic Report reported an increased incidence of chronic hypertension in allpregnant women from 11.9 in 2008 to 12.

7 per 1000 in 2009. The rates of chronichypertension were also noted to increase steadily with age, whereas rates of gestationalhypertension were stable for women under 40 years but increased sharply afterage 40.(16) Approximately300,000 deliveries reported that severe maternal morbidity was associated withhypertensive disorders of pregnancy in the United States.(17) Rural–urban andmarked geographic variation were found with rates for pre-eclampsia rangingfrom as low as 33% (Haryana) to 87.

5% (Tripura).(18)The global prevalences of HDP,gestational hypertension and preeclampsia are 5.2–8.2%, 1.8–4.

4% and 0.2–9.2%,respectively.

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(19) According toregion, the prevalence of PREECLAMPSIAis0.5–2.3% in Africa, 0.2–6.7% in Asia,2.8–9.2% in Oceania, 2.8–5.

2% in Europe, 2.6–4.0% in North America and 1.8–7.7%in South America and the Caribbean.(19)Astudy conducted in 2014 showed results that among the 1694 delivery cases examined, 173 cases had hypertension (9.

8%).Among these, 75 (45%) had gestational hypertension; 24 (14.8%) hadpreeclampsia-eclampsia; 30 (18%) had preeclampsia superimposed on chronichypertension; 21 (13.5%) cases had chronic hypertension; and 13 (8%) hadpregnancy-aggravated chronic hypertension. Ninety-six point three percent(96.3%) had a systolic blood pressure (BP) of 140 – 190 mmHg, and 3.

7% had asystolic BP greater than 190 mmHg. Whereas 61.1% of diastolic blood pressure 90- 110 mmHg and 38.9% of the mothers had diastolic BP greater than 110 mmHg. TheHELLP (Hemolysis, Elevated Liver enzymes & Low Platelet count) syndrome waspresent in 4.9% of cases; 52.6% experienced premature delivery; 7.4% had IUFD(intra uterine fetal death); 9.9% had IUGR (intrauterine growth retardation);and 17.3% had LBW babies.(20)  

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