Open Access Review Article

Hypertension in Pregnancy: A Review

Omar Elsaka

Asian Journal of Pregnancy and Childbirth, Page 1-14

Background: Hypertension affects 10% of pregnancies in the US and is the leading cause of maternal and infant mortality. Hypertension during pregnancy involves several conditions, particularly preeclampsia, a type of hypertension that differs from pregnancy, which is more de Novo or chronic hypertension. Risks to the fetus include premature birth, stunted growth, and death. Childbirth is a direct treatment for preeclampsia. Treatment of acute hypertension is necessary to prevent cerebrovascular, cardiac, and renal problems in the mother. The other two types of hypertension, chronic and transient hypertension, are usually very bad. Proper management of hypertension during pregnancy requires consideration of various factors in the cardiovascular physiology of pregnancy. The main goal is to prevent complications in the mother associated with impaired uterine blood flow and fetal blood circulation. Before prescribing an antihypertensive drug, it is important to carefully evaluate the potential risk to the fetus from the interaction of uterine drugs. This review article aims to show the investigations and treatment available in cases of preeclampsia.

Conclusion: The ultimate goal of treating high blood pressure during pregnancy is to have a healthy newborn without harming the mother's health.

Open Access Review Article

Cesarean Birth among Women Birthing in Asia: A Literature Synthesis using the Robson 10-Group Classification System

Antita Kanjanakaew, Martha Driessnack, Ellen L. Tilden

Asian Journal of Pregnancy and Childbirth, Page 15-31

There are increasing concerns about the advancing rates of Cesarean Birth (CB) worldwide as well as in Asia. However, less is known about the antecedent events and/or indicators contributing to rising CB rates. The Robson 10-Group Classification System (TGCS) facilitates comparisons of CB rates among subgroups of women with similar characteristics. While studies using the Robson TGCS have been conducted in Asia, findings from these studies have not been synthesized. This review article aimed to synthesize and critique the literature examining CB among women birthing in Asia using the Robson TGCS from January, 2011 to June, 2021. Of 396 publications, 25 studies met the inclusion criteria, were analyzed, and synthesized in this literature review. The findings show that the primary contributor to rising CB numbers/rates in Asian countries was Group 5 (multiparous women with a history of CB) followed by Group 2 (nulliparous women with induced labor or CB before labor began). Groups 6, 7, and 9 (women with fetal malpresentations) were the lowest contributors to overall CB rates. There was minimal variation in the distribution of Robson Groups across regions and HDI levels in Asia. The lack of consistency in reporting maternal age challenged understanding regarding the association between maternal age and Robson Group CB distribution patterns. Use of the Robson TGCS provides meaningful insight into antecedent events and indicators of CB numbers/rates. Future research should document maternal age, as prior literature suggests that older maternal age at delivery is associated with higher CB risk. These insights can provide opportunities for increased understanding of rising CB rates in Asia and, ultimately, the development of targeted and tailored interventions.