Diabetes, Hypertension and Metabolic Syndrome

Gestational hypertension

Gestational hypertension or pregnancy-induced hypertension (PIH) is the development of new hypertension in a pregnant woman after 20 weeks’ gestation without the presence of protein in the urine or other signs of preeclampsia and eclampsia. Gestational hypertension is usually defined as having a blood pressure higher than 140/90 measured on two separate occasions, more than 6 hours apart, without the presence of protein in the urine and diagnosed after 20 weeks of gestation. There is no specific treatment, but is monitored closely to rapidly identify pre-eclampsia and its life-threatening complications.

Drug treatment options are limited, as many antihypertensive 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.

During gestational hypertension, a woman must be offered an integrated package of care, covering admission to hospital, treatment, measurement of blood pressure, testing for proteinuria and blood tests.

Gestational hypertension in a future pregnancy ranges from about 1 in 8 (13%) pregnancies to about 1 in 2 (53%) pregnancies.