How intensively should women with mild to moderate chronic hypertension be monitored for complications and with what tests?
This evidence report shows that these clinically salient questions are not well addressed with rigorously designed research. A pervasive problem is that the evidence base on chronic hypertension in pregnancy is small. There are few studies, and available studies typically have small numbers of participants and low power to detect moderate or sometimes large effects for important outcomes. A potpourri of women with different “high risk” obstetrical conditions has been studied, which complicates interpretation of results and alters precision of outcome measurements. Potential adverse effects of many antihypertensive drugs in pregnancy are either poorly established or unclearly quantified because of selection biases and coincidental occurrences that are reported in case reports and surveillance studies. Virtually no relevant research data with important outcomes are available to guide selection of fetal monitoring strategies in pregnant women with chronic hypertension. Advancement of clin
