The etiology and pathogenesis of gestational hypertension
and preeclampsia remain unknown. Despite all the
recent research efforts, there are no reliable tests to
predict the development of preeclampsia and there are
no effective therapeutic methods to prevent preeclampsia.
As a result, gestational hypertension and preeclampsia
remain a major obstetric problem, accounting for a
large percentage of maternal and perinatal morbidities.
At present, there are few, if any, multicenter randomized
studies available to evaluate the safety and efficacy of the
various fetal evaluation techniques or of the various
antihypertensive drugs recommended during the management
of gestational hypertension and preeclampsia.
There is solid evidence to treat severe hypertension and
to use magnesium sulfate as a prophylaxis against convulsions
in women with severe disease. However, there
are inadequate data to support the use of magnesium
sulfate in women with mild gestational hypertension or
mild preeclampsia. Therefore, until multicenter trials are
performed in this area, management of women with
preeclampsia will continue to be based on consensus and
expert opinion.