Gestational hypertension

Gestational hypertension is defined as a blood pressure (BP) of ≥140/90 mmHg on two occasions (at least 4 hours apart) after 20 weeks' gestation in a previously normotensive woman, without the presence of proteinuria or other clinical features (thrombocytopenia, impaired renal or kidney function, pulmonary oedema, or new-onset headache) suggestive of pre-eclampsia.

Women with gestational hypertension are usually asymptomatic.

Women require regular monitoring of BP and urinalysis during the pregnancy to exclude pre-eclampsia.

Hypertension (systolic BP of 140 mmHg or more or diastolic BP of 90 mmHg or more, or both) is managed with lifestyle modification and/or antihypertensive therapy.

Severe hypertension (BP ≥160/110 mmHg) requires admission to hospital 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 after 20 weeks' gestation in a previously normotensive woman, without the presence of proteinuria (<300 mg in 24 hours) or other clinical features (thrombocytopenia, impaired renal or kidney function, pulmonary oedema, or new-onset headache) suggestive of pre-eclampsia.[1]American College of Obstetricians and Gynecologists. ACOG practice bulletin no. 222: gestational hypertension and preeclampsia. Jun 2020 [internet publication]. https://www.acog.org/clinical/clinical-guidance/practice-bulletin/articles/2020/06/gestational-hypertension-and-preeclampsia http://www.ncbi.nlm.nih.gov/pubmed/32443077?tool=bestpractice.com ​​​[2]Brown MA, Magee LA, Kenny LC, et al; International Society for the Study of Hypertension in Pregnancy (ISSHP). 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 ​​