New treatment policy for hypertension late in pregnancy

Inducing labour in pregnant women with hypertension or pre-eclampsia instead of waiting and seeing reduces the chance of complications for the mother. It also reduces the number of caesareans, while the health of the child is unaffected. This has been revealed by a large-scale research project in the Netherlands conducted by Corine Koopmans of the Department of Gynaecology and Obstetrics of the UMCG. Nationally and internationally, the results have led to changes in the standards for treating pregnant women with hypertension after 37 weeks of pregnancy. Koopmans will be awarded a PhD for her research on 12 January 2011 by the University of Groningen.

Between 6 and 8% of pregnant women develop hypertension during pregnancy. In the Netherlands, this is the most important cause of maternal mortality. The syndrome itself is often mild, but it can lead to serious complications. In the Netherlands, and also worldwide, there was previously no agreement about the best policy for hypertension at the end of the pregnancy. Within the obstetrics research consortium of Dutch gynaecologists, Corine Koopmans of the UMCG compared the effects of inducing labour with the usual wait-and-see policy.

The research has shown that inducing labour reduces the chances of complications for the mother when compared with the wait-and-see policy. For the 756 women with hypertension or pre-eclampsia who took part in the research, the chances of complications dropped from 44% to 31%. The number of caesareans also dropped from 19% to 14% as a result of inducing labour. The health of the child when labour is induced is similar to that with the wait-and-see policy. All in all, inducing labour is on average EUR 800 cheaper than the wait-and-see policy.

The results of the research have led to new treatment guidelines both nationally and internationally for this patient group. Inducing pregnancy when there is hypertension or pre-eclampsia during pregnancy has been included in the Dutch guidelines and is now the standard within the internationally renowned guidelines of the British NICE institute. In the Netherlands, the national cooperation in the research has already led to an increase in the percentage of induced labour in this group of women from 58% to 67%, and the percentage of women with a serious complication as a result of hypertension has fallen from 0.85% to 0.19%.

Curriculum Vitae

Corine Koopmans (Leeuwarden, 1979) studied medicine at the University of Groningen. She conducted her PhD research during her specialization at the Department of Gynaecology and Obstetrics of the UMCG. The research was financed by ZonMw. Her supervisors were Prof. P.P. van den Berg, Prof. J.G. Aarnoudse and Prof. B.W. Mol. The title of her thesis is ‘Management of gestational hypertension and mild pre-eclampsia at term’. Koopmans will continue her specialization after being awarded her PhD.

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