Gestational hypertension

Gestational hypertension or pregnancy-induced hypertension (PIH) is defined as the development of new arterial hypertension in a pregnant woman after 20 weeks gestation without the presence of protein in the urine.



Conditions


There exist several hypertensive states of pregnancy:
Gestational hypertension
Gestational hypertension is usually defined as having a blood pressure higher than 140/90 without the presence of protein in the urine.
Preeclampsia
Pre-eclampsia is gestational hypertension (blood pressure greater than 140/90) plus proteinuria (>300 mg of protein in a 24-hour urine sample). Severe preeclampsia involves a blood pressure greater than 160/110, with additional medical signs and symptoms.
Eclampsia
This is when tonic-clonic seizures appear in a pregnant woman with high blood pressure and proteinuria.
HELLP syndrome
This is a dangerous combination of three medical conditions: hemolytic anemia, elevated liver enzymes and low platelet count.
Acute fatty liver of pregnancy
This is sometimes included in the preeclamptic spectrum.
Pre-eclampsia and eclampsia are sometimes treated as components of a common syndrome.




Risk factors

Family history of preeclampsia
Pre-existing hypertension
Renal disease
Diabetes mellitus
Obesity
Multiple gestation (twins or triplets, etc.)
Age 35 or greater
Adolescent pregnancy
African-American race




Treatment


There is no specific treatment, but is monitored closely to rapidly identify pre-eclampsia and its life-threatening complications (HELLP syndrome and eclampsia).
Drug treatment options are limited, as many antihypertensives may negatively affect the fetus; methyldopa, hydralazine and labetalol are most commonly used for severe pregnancy hypertension.
The fetus is at increased risk for a variety of life-threatening conditions, including pulmonary hypoplasia (immature lungs). If the dangerous complications appear after the fetus has reached a point of viability, even though still immature, then an early delivery may be warranted to save the lives of both mother and baby. An appropriate plan for labor and delivery includes selection of a hospital with provisions for advanced life support of newborn babies.



All about pregnancy:

• Pregnancy
• Complications of pregnancy
• Abortion
• Abortion law
• Health risks of unsafe abortion
• Drugs in pregnancy
• Immune tolerance in pregnancy
• Nutrition and pregnancy
• Prenatal care
• Maternal physiological changes in pregnancy
• Prenatal development
• Human embryogenesis
• Implantation (human embryo)
• Human fertilization
• Obstetrics
• Postnatal
• Sex during pregnancy
• Sex after pregnancy