Hipertensão gestacional
Summary
Definition
History and exam
Key diagnostic factors
- presença de fatores de risco
- previamente normotensa
- pressão arterial (PA) ≥140/90 mmHg
Other diagnostic factors
- >20 semanas de gestação
- ausência de sintomas que sugerem pré-eclâmpsia
Risk factors
- nulíparas
- idade materna >35 anos
- etnia negra ou hispânica
- obesidade
- mãe nascida com tamanho pequeno para a idade gestacional
- diabetes mellitus do tipo 1
- enxaqueca
Diagnostic tests
1st tests to order
- urinálise
- Hemograma completo
- TFHs
- eletrólitos, ureia, creatinina
- fator de crescimento placentário
Tests to consider
- ácido úrico
- monitoramento da pressão arterial (PA) por 24h
- ultrassonografia fetal
- velocimetria da artéria umbilical por Doppler
- proteinúria (testes químicos, coleta de urina de 24 horas)
Treatment algorithm
antes do parto
depois do parto
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.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
References
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
- Pré-eclâmpsia
- Eclâmpsia
- Hipertensão essencial
More DifferentialsGuidelines
- Hypertension in pregnancy guideline
- Hypertension in pregnancy: diagnosis and management
More GuidelinesPatient information
Diabetes do tipo 2: devo tomar insulina?
Diabetes: o que posso fazer para me manter saudável?
More Patient information
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