Gestational hypertension

Last reviewed: 2 Jun 2022
Last updated: 29 Jan 2020

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors
  • previously normotensive
  • BP ≥140/90 mmHg
More key diagnostic factors

Other diagnostic factors

  • >20 weeks' gestation
  • absence of symptoms that suggest pre-eclampsia
Other diagnostic factors

Risk factors

  • nulligravidity
  • black or Hispanic ethnicity
  • obesity
  • mother being small for gestational age
  • type 1 diabetes mellitus
  • migraine
More risk factors

Diagnostic investigations

1st investigations to order

  • urinalysis
  • FBC
  • LFTs
  • electrolytes, urea, creatinine
  • uric acid
More 1st investigations to order

Investigations to consider

  • 24-hour BP monitoring
  • fetal ultrasound
  • proteinuria (spot testing, 24-hour urine collection)
More investigations to consider

Treatment algorithm

ACUTE

<37 weeks' gestation

≥37 weeks' gestation

Contributors

Authors

Aparna Sundaram, DO, MBA, MPH

Board-certified, General Preventive Medicine & Public Health

Preventive Medicine Consultants, PLLC

Peoria

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

    • Pre-eclampsia
    • Eclampsia
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  • Guidelines

    • Gestational hypertension and preeclampsia
    • Perinatal forms guideline: a guide for completion of the British Columbia maternal and fetal levels of service classification tool (PSBC 1589)
    More Guidelines
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