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Hypertension and
Pregnancy
Chapter 13
Ashwinee Natu
❍ What is the incidence of hypertensive disease in pregnancy?
12% to 22%.
❍ What is gestational hypertension?
A systolic blood pressure level of 140 mmHg or higher or a diastolic blood pressure level of 90 mmHg or higher
that occurs after 20 weeks of gestation in a woman with previously normal blood pressure, and blood pressure
returns to normal within 12 weeks postpartum.
❍ How should gestational hypertension be definitively diagnosed?
The elevated blood pressure should be documented on two separate occasions at least 6 hours apart, but no
7 days apart.
❍ What is preeclampsia?
Hypertension (as defined before) with proteinuria (urinary excretion of 300 mg protein or higher in a 24-hour
urine specimen or persistent 1+ or more on dipstick in random urine samples).
❍ What is eclampsia?
Presence of new onset grand mal seizures (that cannot be attributed to other causes) in a woman with
preeclampsia.
❍ What is superimposed preeclampsia?
New onset proteinuria in a woman with hypertension before 20 weeks of gestation, a sudden increase in
proteinuria if already present in early gestation, a sudden increase in hypertension, or the development of HELLP
syndrome.
❍ What is HELLP syndrome?
Hemolysis, elevated liver enzymes, and thrombocytopenia that may occur independently or in up to 20% of cases
of severe preeclampsia.