Gestational hypertension

Defined by blood pressure (BP) ≥140/90 mmHg on two occasions (at least 4 hours apart) during pregnancy after 20 weeks' gestation in a previously normotensive patient, without the presence of proteinuria or other clinical features suggestive of pre-eclampsia (thrombocytopenia, impaired renal or kidney function, pulmonary oedema, or new-onset headache).

Patient is usually asymptomatic.

Patient requires regular monitoring of BP and urinalysis during the pregnancy to exclude pre-eclampsia and gestational diabetes.

Mild hypertension is managed with lifestyle modification and antihypertensive therapy.

Severe hypertension (BP ≥160/110 mmHg) requires admission for antihypertensive therapy.

For women ≥37 weeks' gestation, induction should be considered.

Gestational hypertension is defined by BP readings of ≥140/90 mmHg on two occasions at least 4 hours apart during pregnancy after 20 weeks’ gestation in a previously normotensive patient, without the presence of proteinuria (<300 mg in 24 hours) or other clinical features suggestive of of pre-eclampsia (thrombocytopenia, impaired renal or kidney function, pulmonary oedema, or new-onset headache).[1]American College of Obstetricians and Gynecologists. Gestational hypertension and preeclampsia. Obstet Gynecol. 2019 Jan;133(1):e1-25. http://www.ncbi.nlm.nih.gov/pubmed/30575675?tool=bestpractice.com [2]Sibai BM. Diagnosis and management of gestational hypertension and preeclampsia. Obstet Gynecol. 2003 Jul;102(1):181-92. http://www.ncbi.nlm.nih.gov/pubmed/12850627?tool=bestpractice.com [3]Brown MA, Magee LA, Kenny LC, et al. The hypertensive disorders of pregnancy: ISSHP classification, diagnosis & management recommendations for international practice. Pregnancy Hypertens. 2018 Jul;13:291-310. http://www.ncbi.nlm.nih.gov/pubmed/29803330?tool=bestpractice.com [4]Gregg AR. Hypertension in pregnancy. Obstet Gynecol Clin North Am. 2004 Jun;31(2):223-41;v. http://www.ncbi.nlm.nih.gov/pubmed/15200962?tool=bestpractice.com