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Hypertension in pregnancy 

Hypertension in pregnancy

Chapter:
Hypertension in pregnancy
Author(s):

C.W.G. Redman

DOI:
10.1093/med/9780199204854.003.1404
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date: 21 July 2017

In normal pregnancy the arterial pressure falls in the second half of the first trimester: systolic pressure then remains unchanged throughout pregnancy, with diastolic pressure tending to rise gradually towards its prepregnancy level in the later weeks.

Definitions, epidemiology and clinical features—(1) Pregnancy-induced hypertension (PIH), transient hypertension of pregnancy, or gestational hypertension describe new hypertension, defined as blood pressure equal to or in excess of 140/90 mmHg, which without proteinuria affects up to 10% of women after mid term (20 weeks) and resolves after delivery. (2) Pre-eclampsia, which affects 3 to 5% of pregnancies, is defined by the presence of PIH and pregnancy-induced proteinuria arising after 20 weeks gestation that both improve after delivery. Other features include (a) renal insufficiency; (b) hepatocellular dysfunction and/or severe epigastric/right upper quadrant pain; (c) neurological problems—convulsions (eclampsia), severe headaches, persistent scotomata; (d) haematological disturbances—thrombocytopenia, disseminated intravascular coagulation, haemolysis; (e) fetal growth restriction....

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