A short article newly published in the American Journal of Kidney Disease reviews the classification of hypertensive disorders during pregnancy with a case study—and a quiz.1
Because primary care clinicians have clinical encounters with pregnant women, an updated review—and a quiz—seems timely.
Categories of hypertension
Table — 4 Categories of Hypertension in Pregnancy
1. Preeclampsia-eclampsia: new-onset hypertension in pregnancy (>140/90 mm Hg) with proteinuria (protein/creatinine >300mg/g) after 20 weeks of gestation.
2. Chronic hypertension: a blood pressure of >140/90 mm/Hg that predates conception or is diagnosed before 20 weeks of pregnancy.
3. A patient with chronic hypertension may also develop superimposed preeclampsia.
4. Gestational hypertension: new-onset hypertension (blood pressure >140/90 mm Hg) after 20 weeks of pregnancy without proteinuria that resolves after delivery.
Differentiating among these categories is important. Preeclampsia-eclampsia may be associated with serious complications and requires specialty input.
The correct answers are A, C, and D
Acute renal failure during the course of preeclampsia-eclampsia is usually mild and reversible in contrast to pregnancy-related TTP or HUS.
Please click here for a second quiz question and references.