The weight" of fetal growth restriction in 437 hypertensive pregnancies."

OBJECTIVE: Our objective was to evaluate the outcomes of the hypertensive and preeclamptic pregnancies with or without fetal growth restriction (FGR). METHODS: We retrospectively studied 437 hypertensive pregnant women treated by calcium antagonists and divided in four groups: Gestational hypertension (GH) with or without FGR (GH-AGA: 244; GH-FGR: 78) and preeclampsia (PE) with or without FGR (PE-AGA: 76; PE-FGR: 39). Outcomes considered were: the need for a second-line treatment, prolongation of the pregnancy after diagnosis, duration of treatment in puerperium, gestational age at delivery, neonatal birth weight, perinatal mortality and neonatal malformations. RESULTS: A second line treatment was added in: GH-AGA: 15.4% vs. GH-FGR: 32.8%; PE-AGA: 28% vs. PE-FGR: 50%. We found a significant difference in delivery delay after diagnosis (31.3+/-5.4 vs. 20.7+/-3.4 days and 35.3+/-4.5 vs. 22.2+/-3.1; p<0.001). Gestational age at delivery was (p<0.001): 35.5+/-2.3 vs. 35.6+/-2.5 and 34.4+/-1.7 vs. 33.1+/-2.3. A significant difference in birth weight was (p<0.001): 2,271+/-759.1 vs. 1,817.59+/-396.9 and 2,196+/-685.17 vs. 1,465.80+/-441.7. Mortality was 2.56% (2 cases) for GH-FGR and 10.2% (4 cases) for PE-FGR. No neonates showed malformations. CONCLUSIONS: Gestational hypertension and preeclampsia increase the risk of low birth weight, on the other hand the fetal growth restriction is a determinant factor for the outcome of hypertensive and preeclamptic pregnancy, perinatal morbidity and mortality of the fetus and for the management and treatment efficacy of the mother.