A 32-year-old primigravida at 39 weeks of gestational age has a blood pressure reading of 150/100 mm Hg obtained during a routine visit. Her baseline blood pressure during the pregnancy was 120/70 mmHg. The patient denies any headache, visual changes, nausea, vomiting, or abdominal pain. Her repeat BP is 160/90 mmHg, and urinalysis is negative for protein. Which of the following is the most likely diagnosis?
Ans. is 'd' i.e., Gestational hypertension * Hypertension in pregnancy is defined as blood pressure of 140/90 mmHg or greater on at least two separate occasions that are 6 h or more apart. The presence of edema is no longer used as a diagnostic criterion because it is so prevalent in normal pregnant women. A rise in systolic blood pressure of 30 mmHg and a rise in diastolic blood pressure of 15 mmHg are also no longer used.* In gestational hypertension, maternal blood pressure reaches 140/90 or greater for the first time during pregnancy, and proteinuria is not present. In preeclampsia, blood pressure increases to 140/90 after 20 weeks of gestation and proteinuria is present (300 mg in 24 h or 1+ protein or greater on dipstick). Eclampsia is present when women with preeclampsia develop seizures.* Chronic hypertension is defined as BP >140/90 mmHg before pregnancy or diagnosed before 20 weeks of gestation, or hypertension first diagnosed after 20 weeks of gestation and persistent after 12 weeks postpartum.* A woman with hypertension who develops preeclampsia is described as having chronic hypertension with superimposed preeclampsia.
Preeclampsia
Chronic hypertension with superimposed preeclampsia
Eclampsia
Gestational hypertension
Hypertensive Disorders in Pregnancy