- 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 and preeclampsia/eclampsia are hypertensive disorders induced by pregnancy; both disorders resolve postpartum. Gestational hypertension is the most common cause of hypertension in pregnant women.
Gestational hypertension is a clinical diagnosis defined by the new onset of hypertension (systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥90 mmHg) at ≥20 weeks of gestation in the absence of 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. Gestational hypertension is severe when systolic blood pressure is ≥160 mmHg and/or diastolic blood pressure is ≥110 mmHg on two consecutive blood pressure measurements at least four hours apart [1-4].
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 new signs of end-organ dysfunction develop
●Chronic (primary or secondary) hypertension, if blood pressure elevation persists ≥12 weeks postpartum
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- DIAGNOSTIC EVALUATION
- Measure protein excretion
- Evaluate for features of severe disease
- Perform laboratory evaluation
- Determine the severity of hypertension
- Assess fetal well-being
- RISK OF PROGRESSION TO PREECLAMPSIA
- Blood pressure less than 160/110 mmHg
- - Site of care
- - Patient education and counseling
- - Level of physical activity
- - Low dose aspirin
- - Maternal blood pressure and laboratory monitoring
- - Fetal assessment
- - Antihypertensive therapy
- - Antenatal corticosteroids
- - Timing of delivery
- - Intrapartum management
- Blood pressure greater than 160/110 mmHg
- MATERNAL PROGNOSIS
- Postpartum course
- Recurrence risk
- Long-term prognosis
- PERINATAL OUTCOME
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS