Maternal Health Complications in Hypertensive Disorders

Hypertensive disorders of pregnancy, encompassing gestational hypertension, pre-eclampsia and the haemolysis, elevated liver enzymes and low platelets (HELLP) syndrome, represent a leading cause of maternal morbidity and mortality worldwide. These conditions arise from abnormal placental development and maternal endothelial dysfunction, triggering systemic vasoconstriction, increased vascular permeability and end-organ ischaemia. Clinical manifestations range from mild blood pressure elevation to severe multi-organ involvement, including renal impairment, hepatic rupture, coagulopathy and neurological sequelae. HELLP syndrome often develops in association with pre-eclampsia and may progress rapidly, necessitating urgent delivery to avert life-threatening complications. Early identification of at-risk women, through a combination of maternal risk factors, biomarkers and ultrasound markers, has become central to improved outcomes. Advances in understanding the molecular drivers—such as anti-angiogenic factors, inflammatory mediators and genetic predisposition—have informed refined monitoring protocols and targeted interventions. Globally, the burden of hypertensive pregnancy disorders is exacerbated by uneven access to antenatal care, highlighting the need for scalable predictive tools and evidence-based management strategies that can be implemented across resource settings. Ongoing research aims to translate mechanistic insights into safer therapies, optimise timing of delivery and mitigate long-term cardiovascular risk in both mothers and offspring.

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Maternal Health Complications in Hypertensive Disorders publication trend

The graph below shows the total number of articles in maternal health complications in hypertensive disorders across all publications each year (not limited to Nature Index journals).

Technical terms

Gestational hypertension: New-onset elevated blood pressure (≥ 140/90 mmHg) after 20 weeks of gestation without proteinuria or end-organ damage.

Pre-eclampsia: A multisystem pregnancy disorder defined by hypertension after 20 weeks’ gestation accompanied by proteinuria or signs of maternal organ dysfunction.

HELLP syndrome: A severe form of pre-eclampsia characterised by haemolysis, elevated liver enzymes and low platelet count, often requiring urgent delivery.

MicroRNA: Small non-coding RNA molecules that regulate gene expression post-transcriptionally and serve as circulating biomarkers for pathological processes.

References

1. First-Trimester Screening for HELLP Syndrome—Prediction Model Based on MicroRNA Biomarkers and Maternal Clinical Characteristics. International Journal of Molecular Sciences (2023).
2. First-trimester predictive models for adverse pregnancy outcomes—a base for implementation of strategies to prevent cardiovascular disease development. Frontiers in Cell and Developmental Biology (2024).
3. The Role of Platelet-Activating Factor and Magnesium in Obstetrics and Gynecology: Is There Crosstalk between Pre-Eclampsia, Clinical Hypertension, and HELLP Syndrome?. Biomedicines (2023).
4. Genetic Aspects of Preeclampsia and the HELLP Syndrome. Journal of Pregnancy (2014).