SECONDARY HYPERTENSION-PREGNANCY RELATED HTN

SUMMARY

1. In normal pregnancy, the blood pressure is reduced due to a decrease in systemic vascular resistance. Therefore, the BP should always be < 120/80 in pregnancy.

2. Categories: chronic HTN (before 20 wks), preeclampsia (HTN + proteinuria after 20 wks), gestational HTN (after 20 wks), chronic HTN with preeclampsia (HTN + proteinuria after 20 wks)

3. Eclampsia is defined as grand mal seizures in a woman with preeclampsia or gestational HTN.

4. Preeclampsia more commonly occurs in primigravidas, usually in the 3rd trimester, and resolves after delivery.

5. Risk factors include DM, chronic HTN, multiple gestations & prior preeclampsia.

6. Prevent it with daily Mg intake. Note that treatment of chronic HTN does not prevent it.

7. Pregnant women with HTN are at risk for adverse fetal outcomes if BP is driven too low.

Reference(s)

Wilkinson, I., Furmedge, D. and Sinharay, R. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. Get it on Amazon.
Feather, A., Randall, D. and Waterhouse, M. (2020). Kumar And Clark’s Clinical Medicine. 10th ed. S.L.: Elsevier Health Sciences. Get it on Amazon.
Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].