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Gestational hypertension

Last reviewed: 9 Apr 2025
Last updated: 06 Dec 2024

Summary

Definition

History and exam

Key diagnostic factors

  • previously normotensive
  • BP ≥140/90 mmHg
Full details

Other diagnostic factors

  • >20 weeks' gestation
  • absence of symptoms that suggest preeclampsia
Full details

Risk factors

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

Diagnostic tests

1st tests to order

  • urinalysis
  • CBC
  • LFTs
  • electrolytes, BUN, creatinine
  • placental growth factor
Full details

Tests to consider

  • uric acid
  • 24-hour BP monitoring
  • fetal ultrasound
  • umbilical artery Doppler velocimetry
  • proteinuria (spot testing, 24-hour urine collection)
Full details

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.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

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
    More Differentials
  • Guidelines

    • Hypertension in pregnancy guideline
    • Hypertension in pregnancy: diagnosis and management
    More Guidelines
  • Patient information

    Diabetes type 2: should I take insulin?

    Diabetes type 2: what treatments work?

    More Patient information
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