What type of blood pressure is this?
A 35-year-old bus driver comes to your office for a prenatal visit. She is approximately 28 weeks pregnant and has had no complications. She is complaining only of heartburn and has had no fatigue, headaches, leg swelling, contractions, leakage of fluid, or bleeding. On examination her blood pressure is 142/92 and her urine shows no glucose, protein, or leukocytes. Her weight gain is appropriate, with no large recent increases. Fetal tones are 140 and her uterus measures 32 cm from the pubic bone. Looking back through her chart, you see her prenatal blood pressure was 120/70 and her blood pressures during the first 20 weeks were usually 120 to 130/70 to 80.
A) Normotensive for pregnancy
B) Chronic hypertension
C) Gestational hypertension
D) Preeclampsia
C) Gestational hypertension
Gestational hypertension occurs in women who are normotensive before pregnancy and develop systolic pressures over 140 and diastolic pressures over 90 after week 20 of pregnancy. There will be no protein in the urine and no symptoms of preeclampsia such as rapid weight gain, leg edema, or headaches. These patients must be cautioned about symptoms of preeclampsia and receive aggressive follow-up.
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