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Hypertension in Pregnancy

• <500 mL in 24 hours – Severe fetal growth restriction – Pulmonary edema or cyanosis – Cerebrovascular accident 

Chronic Hypertension • “Preexisting Hypertension” • Systolic pressure ≥ 140 mmHg, diastolic pressure ≥90 mmHg, or both. • Present before 20th week of pregnancy or persists longer then 12 weeks postpartum. • 
Chronic Hypertension caused by; – Primary (Essential Hypertension). – Secondary from medical disorders. 

Preeclampsia superimposed upon Chronic Hypertension • Preexisting Hypertension with the following additional signs/symptoms; – New onset proteinuria – Hypertension and proteinuria beginning prior to 20 weeks of gestation. – A sudden increase in blood pressure. – Thrombocytopenia. – Elevated aminotransferases. 

Gestational Hypertension • Mild hypertension without proteinuria or other signs of preeclampsia. • Develops in late pregnancy. • Resolves by 12 weeks postpartum. • Can progress onto preeclampsia. • Usually when gestational hypertension develops before 30 weeks gestation.

Risk Factors for Hypertension in Pregnancy 

• Nulliparity • Preeclampsia in a previous pregnancy • Age >40 years or <18 years

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