Update on Hypertension in Pregnancy

A short article newly published in the American Journal of Kidney Disease reviews the classification of hypertensive disorders during pregnancy with a case study-and a quiz.¹

Because primary care clinicians have clinical encounters with pregnant women, an updated review-and a quiz-seems timely.

Categories of hypertension

Table - 4 Categories of Hypertension in Pregnancy

1. Preeclampsia-eclampsia: new-onset hypertension in pregnancy (>140/90 mm Hg) with proteinuria (protein/creatinine >300mg/g) after 20 weeks of gestation.

2. Chronic hypertension: a blood pressure of >140/90 mm/Hg that predates conception or is diagnosed before 20 weeks of pregnancy.

3. A patient with chronic hypertension may also develop superimposed preeclampsia.

4. Gestational hypertension: new-onset hypertension (blood pressure >140/90 mm Hg) after 20 weeks of pregnancy without proteinuria that resolves after delivery.

Differentiating among these categories is important. Preeclampsia-eclampsia may be associated with serious complications and requires specialty input.