Overview
Hypertension in
pregnancy is defined as a systolic blood pressure (SBP) of ≥140 mmHg or a diastolic BP
(DBP) of ≥90 mmHg, or both, based on at least two measurements ≥4 hours apart,
as stated in the Introduction
section.
Hypertension is the
most frequently occurring medical condition during pregnancy. A detailed
discussion about the prevalence of hypertension in pregnancy is in the Epidemiology section.
The Pathophysiology section
states that preeclampsia and eclampsia may be associated with immunologic and
angiogenic abnormalities within the placenta. The development process of hypertension
in pregnancy is in this section.
The Risk
Factors section discusses the
conditions associated with the development of preeclampsia and superimposed
preeclampsia in pregnant patients with hypertension.
The categories of
hypertension in pregnancy are enumerated in the Classification section.
Hypertension in Pregnancy_Disease SummaryHistory and Physical Examination
The History section highlights the essential elements of
the medical history that should be assessed in pregnant patients with
hypertension.
The importance of a prenatal checkup to assess
the BP of a pregnant patient suspected of elevated BP is in the Physical Examination section.
Diagnosis
The Diagnosis or Diagnostic Criteria section discusses the diagnosis of preeclampsia (including
atypical and preterm preeclampsia) and enumerates the subclassification and
diagnostic criteria of preeclampsia. The clinical findings to support the
diagnosis of severe preeclampsia are also listed in this section.
Discussions on the
work-up for chronic hypertension and other assessments in pregnant women with
suspected hypertension are in the Laboratory
Tests and Ancillaries section.
The Imaging section lists diagnostic tests to assess chronic
hypertension in pregnant patients.
Other clinical syndromes with similar
presentations to preeclampsia and secondary causes of hypertension to consider
are listed in the Differential Diagnosis
section.
Management
Maternal and fetal
monitoring in chronic or gestational hypertension, preeclampsia, and eclampsia
are explained in the Evaluation
section. Indications for delivery and discussion on postpartum hypertension are
also included in this section.
General therapy principles and goals of
treatment in pregnant patients with hypertension are in the Principles of Therapy section.
The Pharmacological
Therapy section discusses in
detail the treatment options and their indications for hypertensive pregnant
patients. Management of preterm preeclampsia is also discussed in this section.
The Nonpharmacological
section includes things to educate the patient and discussion on
lifestyle modification in hypertensive pregnant patients.
The Monitoring section identifies indications to
discontinue antihypertensives in pregnant patients diagnosed with hypertension.
Discussions on postpartum hypertension,
including potential complications, and the management of both mild and severe
hypertension during lactation are in the Complications
section.
