Gestational Hypertension

Hypertension
• Is blood pressure of more than 140 mm Hg systolic or 90 mm Hg
diastolic

Proteinuria
• Urinary protein spillage of
• >300mg/ 24hours
• Protein to creatinine ratio >0.3
• 1+ urinary dipstick reading
Hypertension in Pregnancy
• Major cause of maternal-fetal morbidity and mortality
• 25% of preterm births
 Maternal Risk Factors Maternal Medical Risk Factors

Primiparity
Diabetes Mellitus
Primipaternity
APAS
History of Preeclampsia
SLE
Obesity (BMI of >30)
Renal Disease
Family History of Preeclampsia
Maternal Infection
Ethnicity
UTI
Maternal age
Periodontal Disease
Smoking
Gestational Hypertension
• women whose blood pressures reach 140/90 mm Hg or greater for
the first time after midpregnancy, but in whom proteinuria is not
identified.

• Is a transient hypertension
• preeclampsia does not develop
• blood pressure returns to normal by 12 weeks postpartum.
• Chronic Hypertension: Hypertension present before pregnancy

• Superimposed Preeclampsia: Chronic hypertension in

association with preeclampsia

• Pre-eclampsia: Hypertension + any:

• proteinuria
• BP 160/110 mmHg despite bed rest

• Eclampsia: Pre-eclampsia with convulsions that is cannot be

attributed to another cause.
PREDICTORS OF PRE ECLAMPSIA
• Mean Arterial Pressure
• Doppler Ultrasonography - Uterine Artery Doppler Studies
PREVENTION
• Dietary and Lifestyle Modifications
• Low-Salt Diet
• Calcium Supplementation
• Fish Oil Supplementation
• Exercise

• Antithrombotic Agents
• Low-Dose Aspirin. In oral doses of 50 to 150 mg daily
MANAGEMENT
• The basic management objectives for any pregnancy complicated
by preeclampsia are:
1. termination of pregnancy with the least possible trauma to mother and
fetus
2. birth of an infant who subsequently thrives
3. complete restoration of health to the mother

• One of the most important clinical questions for successful

management is precise knowledge of fetal age.
MANAGEMENT
• Consideration for Delivery
• Termination of pregnancy is the only cure for preeclampsia.
Treatment
• Anti – hypertensives
• Hydralazine
• Beta Blocker
• Methyldopa
• Calcium Channel Blocker
• Magnesium Sulfate