Gestational Hypertension
Article Sections
Introduction
Hypertensive disorders of pregnancy, including gestational hypertension, preeclampsia, and HELLP syndrome (Hemolysis, Elevated Liver enzymes, and Low Platelet count), are likely a spectrum of disease. Gestational hypertension is considered the mildest form and is characterized by new-onset hypertension at ≥20 weeks gestation in the absence of proteinuria and features of end-organ dysfunction.
Preeclampsia and HELLP syndrome are discussed in detail in separate articles.
Pathophysiology and risk factors
The exact pathogenesis of gestational hypertension is not fully understood, but it is believed to start during initial placental development due to improper trophoblastic differentiation and endothelial invasion of the uterine spiral arteries.
The resultant decreased placental perfusion triggers the increased release of antiangiogenic factors, and the decreased release of proangiogenic factors into the maternal circulation. The overall effect is inhibited angiogenesis and widespread maternal endothelial cell dysfunction, resulting in dysregulated vascular tone and systemic hypertension.
Continue Learning with UWorld
Get the full Gestational Hypertension article plus rich visuals, real-world cases, and in-depth insights from medical experts, all available through the UWorld Medical Library.