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Overview :
Hypertension occurring during pregnancy needs to classified
correctly in order to guide medical therapy.
Chronic
hypertension is defined as a blood pressure > 140/90 mm Hg in
(1) a
nonpregnant female
(2) before 20
weeks of gestation
(3) persisting
more than 6 weeks post-partum
Late or
transient hypertension:
(1) development
of hypertension during pregnancy without other signs of pre-eclampsia
Pre-eclampsia:
(1) onset of
hypertension at greater than 20 weeks of gestation with proteinuria and/or
edema
(2)
hypertension: blood pressure greater than 140/90 mm Hg on more than 2 occasions
greater than 6 hours apart
(3)
proteinuria: greater than 300 mg per 24 hours or urine dipstick greater than 1+
on 2 occasions more than 6 hours apart
(4)
hyperuricemia greater than 5 mg/dL
Chronic
hypertension with superimposed pre-eclampsia:
(1)
exacerbation of chronic hypertension greater than 30 mm Hg systolic or 15 mm Hg
diastolic, plus the appearance of significant proteinuria
Severe
pre-eclampsia - when one or more of the following is present:
(1) blood
pressure greater than 160 mm Hg systolic or 110 mm Hg diastolic on 2 occasions
more than 6 hours apart
(2) proteinuria
greater than 5 grams per 24 hours or 3-4+ by dipstick
(3) oliguria
less than 400 mL per 24 hours
(4) cerebral or
visual disturbances
(5) pulmonary
edema or cyanosis
Eclampsia is
defined as the presence of seizures in a patient with preeclampsia.
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