Dear Leticia Carvalho,

Your question on the differences between chronic and gestational hypertension in fetal growth is essential, especially in high-risk pregnancies. As a physician specializing in this area, I would like to offer my perspective based on both the clinical guidelines and my own experience.

Chronic hypertension usually involves pre-existing vascular conditions in the mother. When pregnancy occurs, in addition to this altered cardiovascular structure and factoring in the use of antihypertensive medications, there is often insufficient blood flow to the fetus. This often results in fetal growth restriction. In essence, it is as though the mother's pre-existing condition directly impacts the fetus.

In contrast, gestational hypertension or preeclampsia generally occurs in mothers who have previously had a healthy cardiovascular system. This condition arises as an acute condition during pregnancy. Due to the sudden onset and limited time for the mother's body to adapt, the situation often worsens quickly, affecting fetal growth.Gestational hypertension can be thought of as a disorder affecting not only the mother but also the placenta and, potentially, the fetus itself.

Best regards,

Isil Turan Bakirci

[email protected]

Agree with this suggestion. However, I would like to add that controlled pre-existing hypertension with the safe for the fetus antihypertensive drugs is a relatively safe condition for the mother and the child and will have a little impact for the prognosis. The gestational hypertension, especially the development of the preeclampsia is more serious condition that needs more efforts from the medical care system.

Yuriy M. Sirenko Isil Turan Bakirci

Thank you for your feedback.

So I can say that the two morbidities have different pathophysiology and repercussions for the fetus, correct? Therefore, the groups could not be combined into an analysis.

Absolutely correct

Chronic hypertension can lead to impaired fetal growth due to decreased placental blood flow, resulting in small-for-gestational-age infants. In contrast, gestational hypertension may result in increased fetal growth, potentially leading to larger-than-average babies. However, it’s essential to note that both conditions require close monitoring to manage potential complications and ensure optimal outcomes for both mother and baby.