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Gestational hypertension

Last reviewed: 6 Nov 2023
Last updated: 22 Mar 2023

Summary

Definition

History and exam

Key diagnostic factors

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

Other diagnostic factors

  • >20 weeks' gestation
  • absence of symptoms that suggest preeclampsia
Other diagnostic factors

Risk factors

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

Diagnostic investigations

1st investigations to order

  • urinalysis
  • CBC
  • LFTs
  • electrolytes, BUN, creatinine
  • placental growth factor
More 1st investigations to order

Investigations to consider

  • uric acid
  • 24-hour BP monitoring
  • fetal ultrasound
  • umbilical artery Doppler velocimetry
  • proteinuria (spot testing, 24-hour urine collection)
More investigations to consider

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

    • Hypertensive disorders of pregnancy: diagnosis, prediction, prevention, and management
    • Diagnosis and treatment of hypertension and pre-eclampsia in pregnancy in Aotearoa New Zealand
    More Guidelines
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