- Lissa Magloire, MD
Lissa Magloire, MD
- Texas Perinatal Group
- Edmund F Funai, MD
Edmund F Funai, MD
- Professor and Chief Operating Officer
- USF Health
Gestational hypertension is one of several causes of hypertension in pregnant women. It occurs in about 6 percent of pregnancies .
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 . 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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- RISK OF PROGRESSION TO PREECLAMPSIA
- DIAGNOSTIC EVALUATION
- Measure protein excretion
- Evaluate for signs/symptoms of severe preeclampsia
- Perform laboratory evaluation
- Determine the severity of hypertension
- Assess fetal well-being
- PERINATAL OUTCOME
- Non-severe gestational hypertension
- - Patient education and counseling
- - Fetal assessment
- - No antihypertensive therapy
- - No antenatal glucocorticoids
- - Timing of delivery
- - Intrapartum management
- Severe gestational hypertension
- MATERNAL PROGNOSIS
- Postpartum course
- Recurrence risk
- Long-term prognosis
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS