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Gestational hypertension


Gestational hypertension is one of several causes of hypertension in pregnant women. It occurs in about 6 percent of pregnancies [1].


Gestational hypertension is defined as systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥90 mmHg in a previously normotensive pregnant woman who is ≥20 weeks of gestation and has no proteinuria or new signs of end-organ dysfunction [2]. The blood pressure readings should be documented on at least two occasions at least four hours apart. It is considered severe when sustained elevations in systolic blood pressure ≥160 mmHg and/or diastolic blood pressure ≥110 mmHg are present for at least four hours [2-5].

Gestational hypertension is a temporary diagnosis for hypertensive pregnant women who do not meet criteria for preeclampsia (table 1)) or chronic hypertension (hypertension first detected before the 20th week of pregnancy). The diagnosis is changed to:

Preeclampsia, if proteinuria or signs of end-organ dysfunction develop

Chronic hypertension, if blood pressure elevation persists ≥12 weeks postpartum


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Literature review current through: Mar 2014. | This topic last updated: Nov 8, 2013.
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  1. Yoder SR, Thornburg LL, Bisognano JD. Hypertension in pregnancy and women of childbearing age. Am J Med 2009; 122:890.
  2. American College of Obstetricians and Gynecologists' Task Force on Hypertension in Pregnancy. Hypertension in pregnancy. Obstet Gynecol 2013; 122:1122.
  3. Sibai BM. Diagnosis and management of gestational hypertension and preeclampsia. Obstet Gynecol 2003; 102:181.
  4. Hauth JC, Ewell MG, Levine RJ, et al. Pregnancy outcomes in healthy nulliparas who developed hypertension. Calcium for Preeclampsia Prevention Study Group. Obstet Gynecol 2000; 95:24.
  5. Buchbinder A, Sibai BM, Caritis S, et al. Adverse perinatal outcomes are significantly higher in severe gestational hypertension than in mild preeclampsia. Am J Obstet Gynecol 2002; 186:66.
  6. Villar J, Carroli G, Wojdyla D, et al. Preeclampsia, gestational hypertension and intrauterine growth restriction, related or independent conditions? Am J Obstet Gynecol 2006; 194:921.
  7. Hjartardottir S, Leifsson BG, Geirsson RT, Steinthorsdottir V. Recurrence of hypertensive disorder in second pregnancy. Am J Obstet Gynecol 2006; 194:916.
  8. Brown MA, Mackenzie C, Dunsmuir W, et al. Can we predict recurrence of pre-eclampsia or gestational hypertension? BJOG 2007; 114:984.
  9. Silver HM, Seebeck M, Carlson R. Comparison of total blood volume in normal, preeclamptic, and nonproteinuric gestational hypertensive pregnancy by simultaneous measurement of red blood cell and plasma volumes. Am J Obstet Gynecol 1998; 179:87.
  10. Davis GK, Mackenzie C, Brown MA, et al. Predicting transformation from gestational hypertension to preeclampsia in clinical practice: a possible role for 24 hour ambulatory blood pressure monitoring. Hypertens Pregnancy 2007; 26:77.
  11. Saudan P, Brown MA, Buddle ML, Jones M. Does gestational hypertension become pre-eclampsia? Br J Obstet Gynaecol 1998; 105:1177.
  12. Barton JR, O'brien JM, Bergauer NK, et al. Mild gestational hypertension remote from term: progression and outcome. Am J Obstet Gynecol 2001; 184:979.
  13. Valensise H, Vasapollo B, Novelli GP, et al. Maternal total vascular resistance and concentric geometry: a key to identify uncomplicated gestational hypertension. BJOG 2006; 113:1044.
  14. Noori M, Donald AE, Angelakopoulou A, et al. Prospective study of placental angiogenic factors and maternal vascular function before and after preeclampsia and gestational hypertension. Circulation 2010; 122:478.
  15. Sibai BM. Eclampsia. VI. Maternal-perinatal outcome in 254 consecutive cases. Am J Obstet Gynecol 1990; 163:1049.
  16. Hnat MD, Sibai BM, Caritis S, et al. Perinatal outcome in women with recurrent preeclampsia compared with women who develop preeclampsia as nulliparas. Am J Obstet Gynecol 2002; 186:422.
  17. Knuist M, Bonsel GJ, Zondervan HA, Treffers PE. Intensification of fetal and maternal surveillance in pregnant women with hypertensive disorders. Int J Gynaecol Obstet 1998; 61:127.
  18. Crowther CA, Bouwmeester AM, Ashurst HM. Does admission to hospital for bed rest prevent disease progression or improve fetal outcome in pregnancy complicated by non-proteinuric hypertension? Br J Obstet Gynaecol 1992; 99:13.
  19. Schiff E, Barkai G, Ben-Baruch G, Mashiach S. Low-dose aspirin does not influence the clinical course of women with mild pregnancy-induced hypertension. Obstet Gynecol 1990; 76:742.
  20. Sultan AA, West J, Tata LJ, et al. Risk of first venous thromboembolism in pregnant women in hospital: population based cohort study from England. BMJ 2013; 347:16099.
  21. Corrêa RR, Gilio DB, Cavellani CL, et al. Placental morphometrical and histopathology changes in the different clinical presentations of hypertensive syndromes in pregnancy. Arch Gynecol Obstet 2008; 277:201.
  22. Magee LA, von Dadelszen P, Bohun CM, et al. Serious perinatal complications of non-proteinuric hypertension: an international, multicentre, retrospective cohort study. J Obstet Gynaecol Can 2003; 25:372.
  23. Koopmans CM, Bijlenga D, Groen H, et al. Induction of labour versus expectant monitoring for gestational hypertension or mild pre-eclampsia after 36 weeks' gestation (HYPITAT): a multicentre, open-label randomised controlled trial. Lancet 2009; 374:979.
  24. Nicholson JM, Kellar LC, Kellar GM. The impact of the interaction between increasing gestational age and obstetrical risk on birth outcomes: evidence of a varying optimal time of delivery. J Perinatol 2006; 26:392.
  25. Tajik P, van der Tuuk K, Koopmans CM, et al. Should cervical favourability play a role in the decision for labour induction in gestational hypertension or mild pre-eclampsia at term? An exploratory analysis of the HYPITAT trial. BJOG 2012; 119:1123.
  26. Spong CY, Mercer BM, D'alton M, et al. Timing of indicated late-preterm and early-term birth. Obstet Gynecol 2011; 118:323.
  27. American College of Obstetricians and Gynecologists. ACOG committee opinion no. 560: Medically indicated late-preterm and early-term deliveries. Obstet Gynecol 2013; 121:908.
  28. Cruz MO, Gao W, Hibbard JU. What is the optimal time for delivery in women with gestational hypertension? Am J Obstet Gynecol 2012; 207:214.e1.
  29. Barton JR, Barton LA, Istwan NB, et al. Elective delivery at 34⁰(/)⁷ to 36⁶(/)⁷ weeks' gestation and its impact on neonatal outcomes in women with stable mild gestational hypertension. Am J Obstet Gynecol 2011; 204:44.e1.
  30. Ferrazzani S, De Carolis S, Pomini F, et al. The duration of hypertension in the puerperium of preeclamptic women: relationship with renal impairment and week of delivery. Am J Obstet Gynecol 1994; 171:506.
  31. Reiter L, Brown MA, Whitworth JA. Hypertension in pregnancy: the incidence of underlying renal disease and essential hypertension. Am J Kidney Dis 1994; 24:883.
  32. Wilson BJ, Watson MS, Prescott GJ, et al. Hypertensive diseases of pregnancy and risk of hypertension and stroke in later life: results from cohort study. BMJ 2003; 326:845.
  33. Magnussen EB, Vatten LJ, Smith GD, Romundstad PR. Hypertensive disorders in pregnancy and subsequently measured cardiovascular risk factors. Obstet Gynecol 2009; 114:961.
  34. Robbins CL, Dietz PM, Bombard J, Valderrama AL. Gestational hypertension: a neglected cardiovascular disease risk marker. Am J Obstet Gynecol 2011; 204:336.e1.
  35. Männistö T, Mendola P, Vääräsmäki M, et al. Elevated blood pressure in pregnancy and subsequent chronic disease risk. Circulation 2013; 127:681.