Comparison of Gestational Hypertension and Preeclampsia

High Blood Pressure During Pregnancy: Understanding Gestational Hypertension and Preeclampsia

Pregnancy can be a wonderful time, but it can also come with its own set of challenges. One such challenge is high blood pressure, which can lead to conditions like gestational hypertension and preeclampsia.

Gestational Hypertension

Gestational hypertension is a condition that develops after the 20th week of pregnancy, characterised by high blood pressure (140/90 mm Hg or higher) without protein in the urine or signs of organ dysfunction. It's important to note that gestational hypertension usually resolves after delivery [1][4][5].

Preeclampsia

Preeclampsia, on the other hand, is a more severe condition that involves both high blood pressure and the presence of protein in the urine or signs of organ damage. This can lead to complications such as placental abruption, fetal growth restriction, and increased risk of maternal organ damage and future cardiovascular disease [1][3][4].

Distinguishing Between the Two

The key difference between the two lies in the presence of protein in the urine (proteinuria) and the severity of symptoms. Preeclampsia includes proteinuria or signs of organ damage such as liver or kidney impairment [4].

During pregnancy, signs suggesting preeclampsia over gestational hypertension may include proteinuria on urine testing, symptoms like headaches, vision changes, upper right abdominal pain, and swelling beyond normal pregnancy-related edema. Laboratory evidence of organ dysfunction, more severe fetal growth restriction, or abnormal placental blood flow may also be indicative of preeclampsia [1][4][5].

Symptoms and Risks

While gestational hypertension usually causes no harm to the birthing parent or infant, preeclampsia can be life-threatening to both. In severe cases, preeclampsia can cause low birth weight or preterm birth [2].

Symptoms of preeclampsia may include nausea and vomiting (in the second half of pregnancy), pain in the upper abdomen or shoulder, swelling of the face or hands, a headache that will not go away, sudden weight gain, seeing spots or changes in eyesight, and difficulty breathing [2].

Prevention and Management

To limit complications that could negatively affect the fetus, a person can talk with a healthcare professional about all their options, which may include inducing labor early. Regular check-ups are crucial, and if a person experiences any of the above symptoms of preeclampsia during pregnancy, especially after week 20, they should contact their OB-GYN immediately [3].

It's also worth noting that having gestational hypertension can increase the risk of developing hypertension in the future [6].

Preeclampsia affects pregnancies globally, including in the United States. While rare, preeclampsia symptoms may not start until after birth, which is known as postpartum preeclampsia [2].

References:

[1] American College of Obstetricians and Gynecologists. (2020). Preeclampsia. Retrieved from https://www.acog.org/womens-health/conditions/preeclampsia

[2] Mayo Clinic. (2021). Preeclampsia. Retrieved from https://www.mayoclinic.org/diseases-conditions/preeclampsia/symptoms-causes/syc-20353307

[3] National Health Service. (2021). Preeclampsia. Retrieved from https://www.nhs.uk/conditions/preeclampsia/

[4] World Health Organization. (2018). Classification of Hypertensive Disorders of Pregnancy. Retrieved from https://www.who.int/publications/i/item/9789240014558

[5] American Journal of Obstetrics and Gynecology. (2013). Revised Classification of Hypertensive Disorders of Pregnancy: A Report from the American College of Obstetricians and Gynecologists Task Force on Hypertension in Pregnancy. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3672769/

[6] American Heart Association. (2021). High Blood Pressure During Pregnancy: What You Need to Know. Retrieved from https://www.heart.org/en/health-topics/pregnancy/high-blood-pressure-during-pregnancy

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