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S.0 Mikaye: Hypertension in Pregnancy
Sep 29, 2026, 11:36

S.0 Mikaye: Hypertension in Pregnancy

S.0 Mikaye, Medical Doctor at MSK, shared on LinkedIn:

“Hypertension in Pregnancy

Definition: BP ≥140/90 mmHg during pregnancy. Severe hypertension is ≥160/110 mmHg.

Main types

  1. Chronic hypertension – present before pregnancy or diagnosed before 20 weeks.
  2. Gestational hypertension – develops after 20 weeks without proteinuria or organ dysfunction.
  3. Pre-eclampsia – hypertension after 20 weeks with proteinuria and/or maternal organ dysfunction.
  4. Eclampsia – pre-eclampsia complicated by seizures.
  5. Superimposed pre-eclampsia – pre-eclampsia developing in a woman with chronic hypertension.

Common symptoms of pre-eclampsia

  • Severe headache
  • Blurred vision/visual disturbances
  • Epigastric or right-upper-quadrant pain
  • Shortness of breath
  • Reduced urine output
  • Sudden swelling or weight gain

Assessment

  • Repeated BP measurements
  • Urine protein assessment
  • FBC/platelets
  • Renal and liver function tests
  • Fetal growth and wellbeing assessment

Management

  • Monitor mother and fetus closely.
  • Pregnancy-compatible antihypertensives include labetalol, nifedipine and methyldopa.
  • Severe hypertension requires urgent treatment.
  • Magnesium sulfate is used for seizure prevention/treatment in severe pre-eclampsia/eclampsia.
  • Definitive treatment is delivery, with timing depending on maternal and fetal condition.

Major complications

Mother: eclampsia, stroke, HELLP syndrome, renal failure, pulmonary oedema, placental abruption.

Baby: fetal growth restriction, prematurity, fetal hypoxia and stillbirth.

BP ≥140/90 after 20 weeks + proteinuria or organ dysfunction – pre-eclampsia.”

S.0 Mikaye: Hypertension in Pregnancy

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