Usually asymptomatic. To establish the diagnosis, 2 blood pressure (BP) measurements should be taken at least 6 hours, and no more than 7 days, apart.
Defined by BP ≥140/90 mmHg on 2 occasions during pregnancy after 20 weeks' gestation in a previously normotensive patient, without the presence of proteinuria.
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 over 37 weeks' gestation, induction should be considered.
Gestational hypertension is defined by sustained BP readings of ≥140/90 mmHg during pregnancy after 20 weeks’ gestation in a previously normotensive patient, without the presence of proteinuria (<300 mg in 24 hours). All manifestations of gestational hypertension are presumptive until retrospectively confirmed by complete resolution of hypertension and any other new abnormalities by 12 weeks postpartum; otherwise, other diagnoses should be considered.[1]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
[2]Dolea C, Abou Zahr C; World Health Organization. Global burden of hypertensive disorders of pregnancy in the year 2000. July 2003 [internet publication].
http://www.who.int/healthinfo/statistics/bod_hypertensivedisordersofpregnancy.pdf
[3]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
[4]Koonin LM, MacKay AP, Berg CJ, et al. Pregnancy-related mortality surveillance - United States, 1987-1990. MMWR CDC Surveill Summ. 1997 Aug 8;46(4):17-36.
http://www.cdc.gov/mmwr/preview/mmwrhtml/00048923.htm
http://www.ncbi.nlm.nih.gov/pubmed/9259215?tool=bestpractice.com