💙 Pre-existing (Chronic) Hypertension:
- Present before pregnancy or detected before 20 weeks.
- No proteinuria or oedema.
- Affects ~3–5% of pregnancies, ↑ risk with older mothers.
💛 Pregnancy-induced / Gestational Hypertension:
- New hypertension after 20 weeks.
- No proteinuria or oedema.
- Occurs in ~5–7% of pregnancies.
- Usually resolves within 1 month postpartum, but ↑ future risk of pre-eclampsia or chronic HTN.
❤️ Pre-eclampsia:
- Hypertension + proteinuria (>0.3 g/24h).
- Oedema sometimes present (not essential for diagnosis).
- Occurs in ~5% of pregnancies; risk of maternal & fetal complications.

⚠️ Symptoms of Pre-eclampsia

Pregnant women should seek urgent help if they experience:

💥 Severe headache.
👀 Visual changes (blurring, flashing lights).
⚡ Severe epigastric / RUQ pain.
🤢 Vomiting.
💧 Sudden swelling of face, hands, or feet.

💊 Antiplatelet Agents

Women at high risk of pre-eclampsia → aspirin 75–150 mg daily from 12 weeks until delivery.

Previous hypertensive disorder of pregnancy.
Chronic kidney disease.
Autoimmune disease (SLE, antiphospholipid syndrome).
Type 1 or 2 diabetes.
Chronic hypertension.

🟨 Moderate Risk of Pre-eclampsia

If a woman has ≥2 moderate risk factors, start aspirin 75–150 mg daily from 12 weeks until delivery.

First pregnancy.
Age ≥ 40 years.
Pregnancy interval > 10 years.
BMI ≥ 35 at booking.
Family history of pre-eclampsia.
Multiple pregnancy (twins/triplets).

📚 References

NICE Guidance on Hypertension in Pregnancy

Clinical cases

🤰 Case 1 – Age 28 (Gestational Hypertension): First pregnancy at 32 weeks; routine check revealed BP 148/95 mmHg with normal urine dipstick and bloods. No headache or visual symptoms. Diagnosis: Gestational hypertension (new-onset hypertension after 20 weeks without proteinuria). Management: Started on oral labetalol, weekly BP and urine checks, and growth scans every 2–4 weeks. Teaching point: Gestational hypertension can progress to pre-eclampsia — close surveillance of BP, urine protein, and fetal growth is essential.
🩺 Case 2 – Age 35 (Pre-eclampsia): At 30 weeks, presented with headache and visual disturbance. BP 170/110 mmHg, urine 3+ protein, reflexes brisk. Investigations: Raised urate and abnormal LFTs; normal platelets. Diagnosis: Pre-eclampsia. Management: Hospital admission, IV labetalol to control BP, magnesium sulphate prophylaxis, and corticosteroids for fetal lung maturity. Teaching point: Pre-eclampsia is due to abnormal placental vascular development causing endothelial dysfunction and multi-organ effects — delivery is the definitive cure.
💊 Case 3 – Age 39 (Chronic Hypertension in Pregnancy): Known hypertensive on amlodipine before conception. Early antenatal visit at 10 weeks with BP 142/92 mmHg, normal urine, normal renal function. Management: Switched to labetalol (safe in pregnancy) and started low-dose aspirin from 12 weeks to reduce pre-eclampsia risk. Outcome: Controlled BP throughout pregnancy, delivered at term. Teaching point: Women with pre-existing hypertension need medication review pre-pregnancy — ACE inhibitors and ARBs must be stopped due to teratogenicity.

The content on this website is provided for educational and informational purposes only to support exam preparation (e.g., MLA, MRCP, USMLE) and learning. This is NOT medical advice, diagnosis, treatment, or professional guidance. It does not replace consultation with a qualified healthcare professional, official guidelines (e.g., NICE, GMC, BNF), or supervised clinical practice. Always verify information with current, authoritative sources. Makindo and its contributors accept no liability for any reliance on this content, including errors, omissions, or any resulting harm, loss, or consequences. By using this site, you agree to these terms.

Hypertension in Pregnancy

🌸 Introduction

🗂️ Classification of Hypertension in Pregnancy

⚠️ Symptoms of Pre-eclampsia

💊 Antiplatelet Agents

🟨 Moderate Risk of Pre-eclampsia

📚 References

Clinical cases

Categories