Gestational hypertension

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
Founder, WikiMD Wellnesspedia &
W8MD medical weight loss NYC and sleep center NYC

Gestational hypertension
Hypertrophic decidual vasculopathy
Synonyms	Pregnancy-induced hypertension (PIH)
Pronounce	N/A
Specialty	N/A
Symptoms	High blood pressure, proteinuria, edema
Complications	Preeclampsia, eclampsia, HELLP syndrome, placental abruption
Onset	After 20 weeks of gestation
Duration	Until delivery
Types	N/A
Causes	Unknown, but risk factors include first pregnancy, multiple gestation, obesity, diabetes mellitus, chronic hypertension
Risks	Preterm birth, fetal growth restriction, placental abruption
Diagnosis	Blood pressure measurement, urinalysis
Differential diagnosis	Chronic hypertension, preeclampsia, white coat hypertension
Prevention	Aspirin in high-risk individuals, calcium supplementation
Treatment	Antihypertensive medication, bed rest, induction of labor if necessary
Medication	N/A
Prognosis	Generally good with proper management, but can lead to complications if untreated
Frequency	Affects 6-8% of pregnancies
Deaths	Rare with proper management

Gestational hypertension

Gestational hypertension is a condition characterized by high blood pressure that develops during pregnancy, typically after 20 weeks of gestation, in women who previously had normal blood pressure. It is a form of hypertensive disorders of pregnancy and can lead to serious complications for both the mother and the fetus if not properly managed.

Pathophysiology

The exact cause of gestational hypertension is not fully understood, but it is believed to involve a combination of genetic, environmental, and immunological factors. The condition is thought to result from abnormal placentation, leading to poor placental perfusion and the release of factors that cause widespread endothelial dysfunction and vasoconstriction.

Diagnosis

Gestational hypertension is diagnosed when a pregnant woman has a systolic blood pressure of 140 mmHg or higher, or a diastolic blood pressure of 90 mmHg or higher, on two separate occasions at least four hours apart, after 20 weeks of gestation. Unlike preeclampsia, gestational hypertension is not accompanied by significant proteinuria or signs of end-organ dysfunction.

Management

The management of gestational hypertension involves regular monitoring of blood pressure and fetal well-being. Lifestyle modifications, such as dietary changes and increased physical activity, may be recommended. In some cases, antihypertensive medications may be prescribed to control blood pressure. The choice of medication depends on the severity of hypertension and the gestational age.

Complications

Gestational hypertension can progress to preeclampsia, a more severe condition that poses significant risks to both the mother and the fetus. Other potential complications include placental abruption, preterm birth, and fetal growth restriction. Women with gestational hypertension are also at increased risk of developing chronic hypertension later in life.

Prognosis

With appropriate management, most women with gestational hypertension can expect a favorable outcome. Blood pressure typically returns to normal within 12 weeks postpartum. However, women with a history of gestational hypertension should be monitored for the development of chronic hypertension in subsequent years.

Prevention

There is no guaranteed way to prevent gestational hypertension, but maintaining a healthy lifestyle before and during pregnancy may reduce the risk. This includes regular exercise, a balanced diet, and avoiding smoking and excessive alcohol consumption.

Also see

• Preeclampsia
• Eclampsia
• Chronic hypertension in pregnancy
• Hypertensive disorders of pregnancy