Hypertension in Pregnancy

Question 1

What is the only promising primary preventive method of developing preeclampsia, for women at high risk?

Answer 1

Low-dose aspirin

Question 2

What are the four categories of Hypertensive Disorders of Pregnancy?

Answer 2

1. Gestational Hypertension
2. Preeclampsia-Eclampsia
3. Chronic hypertension
4. Chronic hypertension with superimposed preeclampsia

Question 3

What is Gestational Hypertension?

Answer 3

An elevated blood pressure that is recognized after 20 weeks’ gestation in the absence of proteinuria, preeclampsia symptoms, or abnormal labs

Question 4

If gestational hypertension fails to resolve beyond 12 weeks postpartum, what might it be?

Answer 4

Chronic Hypertension

Question 5

What % of gestational hypertension patients will develop preeclampsia?

Answer 5

15-25%

Question 6

What is Preeclampsia?

Answer 6

New onset hypertension, usually after 20 weeks, with either proteinuria, or s/sx of end-organ involvement. There are two types:
1. Preeclampsia without severe features
2. Preeclampsia with severe features
(this includes HELLP and eclampsia)

Question 7

What is Eclampsia?

Answer 7

When a grand-mal seizure occurs in a woman with preeclampsia, and other neurologic conditions are not present to explain their onset.

Question 8

What is chronic hypertension?

Answer 8

SBP 140+ or DBP 90+ which occurs on more than 1 occasion, at least 4 hours apart. It is diagnosed prior to pregnancy, before 20 weeks, or if it persists beyond 12 weeks postpartum.

Question 9

What is Chronic hypertension with super-imposed preeclampsia?

Answer 9

New onset or worsening of proteinuria or end-organ involvement, or worsening of HTN after 20 weeks in a woman with preexisting chronic hypertension

Question 10

Is proteinuria required for dx of preeclampsia?

Answer 10

Not if new onset hypertension is seen in the presence of end-organ involvement

Question 11

What % of preeclampsia-associated complications are potentially preventable?

Answer 11

40%