Summary
Definition
History and exam
Key diagnostic factors
- previously normotensive
- BP ≥140/90 mmHg
Other diagnostic factors
- >20 weeks' gestation
- absence of symptoms that suggest preeclampsia
Risk factors
- nulliparous
- maternal age >35 years
- black or Hispanic ethnicity
- obesity
- mother small for gestational age
- type 1 diabetes mellitus
- migraine
Diagnostic tests
1st tests to order
- urinalysis
- CBC
- LFTs
- electrolytes, BUN, creatinine
- placental growth factor
Tests to consider
- uric acid
- 24-hour BP monitoring
- fetal ultrasound
- umbilical artery Doppler velocimetry
- proteinuria (spot testing, 24-hour urine collection)
Treatment algorithm
before delivery
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.
References
Key articles
American College of Obstetricians and Gynecologists. ACOG practice bulletin no. 222: gestational hypertension and preeclampsia. Jun 2020 [internet publication].Full text Abstract
Magee LA, Brown MA, Hall DR, et al. The 2021 International Society for the Study of Hypertension in Pregnancy classification, diagnosis & management recommendations for international practice. Pregnancy Hypertens. 2022 Mar;27:148-69. Abstract
National Institute for Health and Care Excellence. Hypertension in pregnancy: diagnosis and management. Apr 2023 [internet publication].Full text
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Differentials
- Preeclampsia
- Eclampsia
- Hypertension, essential
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- Hypertension in pregnancy guideline
- Hypertension in pregnancy: diagnosis and management
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