hypertensionpreeclampsia

Hypertensionpreeclampsia refers to the spectrum of hypertensive disorders that can occur during pregnancy, including chronic hypertension, gestational hypertension, and preeclampsia. Preeclampsia is defined as new-onset hypertension after 20 weeks of gestation accompanied by proteinuria or signs of end-organ dysfunction. Proteinuria is typically quantified as ≥300 mg in 24 hours or a protein/creatinine ratio ≥0.3; in some settings, a dipstick result of 1+ may be used cautiously. Severe features include blood pressure ≥160 systolic or ≥110 diastolic on two occasions, thrombocytopenia, elevated liver enzymes, renal impairment, pulmonary edema, or cerebral/visual symptoms.

Risk factors include first pregnancy, history of preeclampsia, chronic hypertension, obesity, diabetes, autoimmune disease, multiple gestation, and advanced maternal age. The underlying pathophysiology involves abnormal placentation with placental ischemia and systemic endothelial dysfunction, leading to hypertension and multi-organ involvement.

Management emphasizes careful maternal–fetal monitoring and delivery planning. Antihypertensive therapy commonly uses labetalol, oral nifedipine, or methyldopa. Magnesium sulfate is given for seizure prophylaxis in preeclampsia with severe features or, in some cases, in eclampsia approaching labor. If preterm birth is anticipated, corticosteroids may be used to accelerate fetal lung maturity. Delivery remains the definitive treatment for preeclampsia; timing depends on gestational age and maternal–fetal status, with milder disease at term often managed expectantly until delivery.

Prevention strategies include low-dose aspirin for high‑risk individuals starting in early pregnancy and ensuring adequate calcium intake in populations with low calcium consumption.