Incidence and risk factors that predict chronic hypertension after delivery in women with hypertensive disorders of pregnancy

Abstract

Hypertensive disorders of pregnancy (HDP) are an important disorder complicating 5% to 10% of all pregnancies and are a leading cause of maternal and fetal morbidity and mortality.

Hypertensive disorders of pregnancy are diagnosed by systolic blood pressure (BP) of 140 mmHg or greater and/or diastolic BP of 90 mmHg or greater on at least two occasions more than 4 hours apart while resting.

Chronic hypertension is diagnosed by blood pressure of 140/90 mmHg or greater present prior to pregnancy, before the 20th week of gestation or persisting beyond the 42nd postpartum day.

Gestational hypertension is diagnosed by blood pressure of 140/90 mmHg or greater that develops beyond 20 weeks’ gestation and usually resolves within 42 days postpartum.

Preeclampsia is diagnosed by systolic blood pressure ≥140 mmHg or diastolic blood pressure ≥90 mmHg on two occasions at least four hours apart after 20 weeks of gestation (if systolic blood pressure is ≥160 mmHg or diastolic blood pressure is ≥110 mmHg, confirmation within minutes is sufficient) and proteinuria.

Proteinuria is defined by ≥0.3 g in a 24-hour urine specimen or protein/creatinine ratio ≥0.3 (mg/mg) or dipstick ≥1+ if a quantitative measurement is unavailable.

Preeclampsia can now be formally diagnosed without proteinuria when hypertension is accompanied by thrombocytopenia, transaminitis, acute kidney injury, pulmonary edema, or new-onset neurologic or visual symptoms.