From the Guidelines
Gestational hypertension is defined as persistent de novo hypertension that develops at or after 20 weeks’ gestation in the absence of features of preeclampsia. This definition is based on the most recent and highest quality study available, which provides a clear and concise description of the condition 1.
Key Characteristics
- Develops at or after 20 weeks’ gestation
- Persistent de novo hypertension
- Absence of features of preeclampsia According to the study published in Hypertension in 2018 1, gestational hypertension is a distinct condition that requires careful management to prevent complications.
Management and Monitoring
- Regular blood pressure monitoring
- Close prenatal visits to assess maternal and fetal well-being
- Possible use of antihypertensive medications if blood pressure becomes severely elevated It is essential to note that gestational hypertension can progress to preeclampsia in some cases, highlighting the importance of regular monitoring and timely intervention 1.
From the Research
Definition of Gestational Hypertension
Gestational hypertension is defined as a systolic blood pressure ≥ 140 mmHg and/or a diastolic blood pressure ≥ 90 mmHg, measured on two separate occasions, developing after 20 weeks of gestation and usually resolving within 6 weeks postpartum 2, 3, 4, 5.
Key Characteristics
- It is classified as mild (SBP 140-149 and DBP 90-99 mmHg), moderate (SBP 150-159 and DBP 100-109 mmHg) and severe (SBP ≥ 160 and DBP ≥ 110 mmHg) 3.
- Gestational hypertension is a major cause of maternal, fetal, and newborn morbidity and mortality 3.
- Women with gestational hypertension are at a greater risk of abruptio placentae, cerebrovascular events, organ failure, and disseminated intravascular coagulation 3.
- Fetuses of these mothers are at greater risk of intrauterine growth retardation, prematurity, and intrauterine death 3.
Diagnosis and Management
- The diagnosis of gestational hypertension is based on blood pressure measurements and the presence of proteinuria 2, 3.
- The management of gestational hypertension depends on blood pressure levels, gestational age, presence of symptoms, and associated risk factors 3.
- Antihypertensive treatment is recommended in pregnancy when blood pressure levels are ≥ 150/95 mmHg, or at values > 140/90 mmHg in women with gestational hypertension (with or without proteinuria) 2, 3.
- Methyldopa, labetalol, and calcium antagonists (such as nifedipine) are the drugs of choice for treating gestational hypertension 2, 3, 5.