Gestational hypertension

The diagnosis for hypertension is done when, between two or more separate test times of 6 hours in difference, a maximum arterial tension (systolic) of ≥ 140 mmHg and/or a minimum arterial tension (diastolic) of ≥ 90 mmHg is observed in the patient. 

Arterial tension increase during pregnancy can be caused by placenta development failures in premature gestation stages that lead to the endangerment of the maternal blood vessels and the development of hypertension as a consequence.

Arterial tension increases in pregnant women presents in different shapes:

• Gestational hypertension: characterized by arterial pressure elevation after the 20th week of pregnancy. There is no excessive protein in the urine or any other signs of organ damage. Over time, it can develop into preeclampsia.
• Chronic hypertension: Blood pressure that was already elevated before pregnancy or that occurs before 20 weeks of pregnancy. However, because high blood pressure usually has no symptoms, it can be difficult to determine when it began.
• Chronic hypertension and superimposed preeclampsia: this alteration develops in women who had chronic hypertension since before their pregnancy. A worsening of the hypertension is observed, and the excessive protein in the urine is added to it, among other complications related to arterial pressure.
• Preeclampsia: appearance of hypertension after the 20th week of pregnancy. Associated with signs of other organ damage such as the kidneys, liver, blood or the brain. If not treated, preeclampsia can generate severe and even fatal complications for the gestating mother and fetus, as well as seizures (eclampsia).

The risk of suffering from gestational hypertension increases when having had a previous pregnancy, if the gestation is multiple (twins or triplets), having suffered from a previous abortion, if the women is in their teens or older than 40 years old.

Sometimes gestational hypertension is asymptomatic but can be suspected from a sudden weight increase, diminution in urine production, swollen face and hands. In complicated cases, headache, abdominal pain, nausea and vomiting, dyspnea (choking or difficulty breathing) or even confusional states may appear.

Hypertension risks during pregnancy vary, such as the following:

• Less placental blood flow with natal development complications.
• Placental abruption.
• Damage to other organs (brain, heart, lungs, kidneys or liver).
• Preterm delivery.
• Future cardiovascular diseases.

The aim of treatment is to prevent the increase in blood pressure and the development of damage to other organs. Initially, lifestyle changes may be sufficient, but most of the time it is necessary to administer antihypertensive drugs.