What is considered a mild range blood pressure for a pregnant female undergoing a preeclampsia workup?

Mild Range Blood Pressure for Preeclampsia Workup

Mild range blood pressure for preeclampsia workup is defined as systolic blood pressure of 140-159 mmHg or diastolic blood pressure of 90-109 mmHg. 1, 2

Blood Pressure Classification in Pregnancy

The standard definition of hypertension in pregnancy differs from non-pregnant populations and is based on absolute blood pressure values rather than grades:

• Mild hypertension: 140-159/90-109 mmHg 1, 2
• Severe hypertension: ≥160/110 mmHg 1, 2

This classification applies specifically to pregnancy-related hypertensive disorders and is endorsed by major international guidelines including the European Society of Cardiology and the International Society for the Study of Hypertension in Pregnancy. 1

Critical Clinical Context

The blood pressure level itself is not a reliable way to stratify immediate risk in preeclampsia. 1 Women may develop serious organ dysfunction, such as renal impairment or neurological complications, at relatively mild levels of hypertension. Therefore, decisions to admit and monitor should be based on having developed preeclampsia regardless of the initial blood pressure levels. 1

Important Caveats:

• There should be no attempt to diagnose "mild versus severe preeclampsia" clinically, as all cases may become emergencies, often rapidly. 1

• Blood pressure ≥160/110 mmHg represents a hypertensive emergency requiring immediate treatment within 15 minutes in a monitored setting to prevent maternal stroke. 3, 4

• Even with blood pressure in the "mild" range (140-159/90-109 mmHg), immediate same-day hospital assessment is required when accompanied by new proteinuria (≥+ on dipstick). 1

When to Escalate Care

Blood pressure in the mild range (140-159/90-109 mmHg) requires urgent escalation when accompanied by:

• New proteinuria (≥+ on dipstick): Refer for same-day hospital assessment 1
• Maternal symptoms (headache, visual disturbances, epigastric pain): Arrange immediate admission 1
• Diastolic ≥100 mmHg alone: Refer for same-day hospital assessment 1

Treatment Thresholds

The International Society for the Study of Hypertension in Pregnancy endorses commencing antihypertensive treatment for any persistent non-severe hypertension (≥140/90 mmHg) well before blood pressures of 160/110 mmHg are reached, to reduce the likelihood of developing severe maternal hypertension. 1 This recommendation applies to all hypertensive disorders of pregnancy. 1

Non-pharmacologic management may be considered for systolic blood pressure of 140-149 mmHg and/or diastolic blood pressure of 90-95 mmHg, depending on gestational age and presence of maternal and fetal risk factors. 1