Usually asymptomatic. To establish the diagnosis, 2 blood pressure (BP) measurements should be taken at least 6 hours, and no more than 7 days, apart.
Defined by BP ≥140/90 mmHg on 2 occasions during pregnancy after 20 weeks' gestation in a previously normotensive patient, without the presence of proteinuria.
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 over 37 weeks' gestation, induction should be considered.
Gestational hypertension is defined by sustained BP readings of ≥140/90 mmHg during pregnancy after 20 weeks’ gestation in a previously normotensive patient, without the presence of proteinuria (<300 mg in 24 hours). All manifestations of gestational hypertension are presumptive until retrospectively confirmed by complete resolution of hypertension and any other new abnormalities by 12 weeks postpartum; otherwise, other diagnoses should be considered.
[1]
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
[2]
Dolea C, Abou Zahr C; World Health Organization. Global burden of hypertensive disorders of pregnancy in the year 2000. July 2003 [internet publication].
http://www.who.int/healthinfo/statistics/bod_hypertensivedisordersofpregnancy.pdf
[3]
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
[4]
Koonin LM, MacKay AP, Berg CJ, et al. Pregnancy-related mortality surveillance - United States, 1987-1990. MMWR CDC Surveill Summ. 1997 Aug 8;46(4):17-36.
http://www.cdc.gov/mmwr/preview/mmwrhtml/00048923.htm
http://www.ncbi.nlm.nih.gov/pubmed/9259215?tool=bestpractice.com