Hypertension in Pregnancy

Description:

Hypertension existing prior to the onset of pregnancy,hypertension diagnosed prior to 20 weeks estimated gestational age, or persistent postpartum hypertension (>12 weeks postpartum).Hypertension diagnosed during pregnancy may be :

-mild: >140/90mm Hg;

-severe: > 160/110mm Hg.

Risk factors:

-Obesity;

-Smoking;

-Family history of HTP;

-Sedentary lifestyle;

-Etnicity (African Americans , Hispanics );

-Stress;

-Drugs (cocaine , methamphetamine).

Associated conditions:

-Renal : glomerulpnephritis , interstitial nefritis ;

-Retinal : retinopathy ;

-Cardiac: cardiomegaly , LVH .

Diagnosis :

-History ;

-Phisical exam ;

-Tests: ECG , Echo ;

-Lab: 24 hour urine for proteine and creatinine clearance , electrolytes , blood urea nitrogen ,creatinine , uric acid , urinalysis , CBS , platelets , AST , ALT , LDH , urine drug screening , echo (fetal and maternal) .

Fetal US : fetal groth .

Maternal US : suspected complications such as CVA , chest pain , dyspnea , cardiac failure or hypertrophy .

Recomandation : patient monitoring .