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 preeclampsia (thrombocytopenia, impaired renal or kidney function, pulmonary edema, or new-onset headache).

Patient is usually asymptomatic.

Patient requires regular monitoring of BP and urinalysis during the pregnancy to exclude preeclampsia 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 preeclampsia (thrombocytopenia, impaired renal or kidney function, pulmonary edema, 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):223-41v. http://www.ncbi.nlm.nih.gov/pubmed/15200962?tool=bestpractice.com