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 (dyastolic) 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 would lead to the endangerment of the maternal blood vessels and the development of hypertension as a consequence.

Arterial tension increases in pregnant women present in different shapes:

• Gestational hypertension: characterised 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 the 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 to signs of other organs 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 foetus, 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 avortion, 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, it can appear cephalea, abdominal pain, nausea, vomits, dyspnea (suffocation or difficulty to breath) or even, confusional states.

Hypertension risks during pregnancy are various, such as the following:

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

The treatment's objective is avoiding an increase in tensional numbers and the development of damage in other organs. At the beginning, it might be enough with some lifestyle changes but most of the times antihypertensive drugs need to be administered.