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Gestational hypertension

Last reviewed: 23 Jun 2024
Last updated: 12 Apr 2024

Summary

Definition

History and exam

Key diagnostic factors

  • previously normotensive
  • BP ≥140/90 mmHg
Full details

Other diagnostic factors

  • >20 weeks' gestation
  • absence of symptoms that suggest preeclampsia
Full details

Risk factors

  • nulliparous
  • maternal age >35 years
  • black or Hispanic ethnicity
  • obesity
  • mother small for gestational age
  • type 1 diabetes mellitus
  • migraine
Full details

Diagnostic tests

1st tests to order

  • urinalysis
  • CBC
  • LFTs
  • electrolytes, BUN, creatinine
  • placental growth factor
Full details

Tests to consider

  • uric acid
  • 24-hour BP monitoring
  • fetal ultrasound
  • umbilical artery Doppler velocimetry
  • proteinuria (spot testing, 24-hour urine collection)
Full details

Treatment algorithm

ACUTE

before delivery

ONGOING

after delivery

Contributors

Authors

Aparna Sundaram, DO, MBA, MPH

Board-certified in Preventive Medicine

Board Certified in Lifestyle Medicine

Preventive Medicine Consultants, PLLC

Glendale

AZ

Disclosures

AS declares that she has no competing interests.

Peer reviewers

Caroline Apovian, MD

Associate Professor of Medicine

Boston University School of Medicine

Boston

MA

Disclosures

CA declares that she has no competing interests.

James Walker, MD, FRCP(Glas), FRCP(Edin), FRCOG

Professor of Obstetrics and Gynaecology

St James's University Hospital

Leeds

UK

Disclosures

JW declares that he has no competing interests.

  • Differentials

    • Preeclampsia
    • Eclampsia
    • Hypertension, essential
    More Differentials
  • Guidelines

    • Hypertension in pregnancy: diagnosis and management
    • Diagnosis and treatment of hypertension and pre-eclampsia in pregnancy in Aotearoa New Zealand
    More Guidelines
  • Patient information

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