Book of Medical Disorders in Pregnancy - Tintash

Chapter No 4
Introduction
HYPERTENSIVE DISEASE IN PREGNANCY
Hypertension - is considered present
when diastolic B.P. is greater than 90
mm Hg or the increase is greater than 15
mm Hg over pre-pregnancy pressure, or
Systolic B.P. is greater than 140 mm Hg
or the increase is greater than 30 mm Hg
over pre-pregnancy level. "The increase
in pressure should manifest on two
occasions more than 6 hours apart.
Checking blood pressure
Fig 4.1: Shows position of blood
pressure measuring cuff zero point at
zero pressure in chest
Zero Pressure is found in right atrium
the level of right atrium of the heart
should be kept in mind while applying
blood pressure measuring cuff.
Gestational hypertension - This is
defined as blood pressure elevated at
gestational age greater than 20 weeks or
within 24-hour of delivery (most likely it
is a variant of pre-eclamptic toxemia.
The designation of hypertensive states of
pregnancy is usually limited to preeclampsia,
eclampsia, and chronic hypertensive
vascular disease with superi-
40
mposed preeclampsia or eclampsia. The
available clinical criteria
Fig 4.2; Shows various types of
hypertension
Classification:
The student must realize that diagnosis
based on clinical features alone is not
always valid. The diagnosis of some of
these conditions can only be possible by
retrospective analysis, there-fore the
classification presented here is only an
arbitrary one. The disease can be divided
into four groups for descriptive
purposes.
Pregnancy induced hypertension:
Chronic hypertension preceding pregnancy.
Chronic hypertension with superimposed
toxemia Latent or transient hypertension.