Hypertension during pregnancy is a medical condition that requires specific care and attention, given the significant impact it can have on both the mother and the baby.
Below, we will analyze the different scenarios of gestational hypertension and the criteria for intervention based on the data presented.
Types of Gestational Hypertension
Hypertension during pregnancy can be categorized in various ways, depending on the severity and characteristics of the condition:
Controlled chronic hypertension (CCH) without antihypertensive: This refers to a condition where chronic hypertension is controlled without the use of blood pressure-lowering medications.
Controlled CCH with antihypertensive: In this case, chronic hypertension is controlled with the use of medications.
Uncontrolled CCH: Refers to chronic hypertension that remains elevated despite the use of medications.
Gestational hypertension and preeclampsia (PE) with severe features: A condition where hypertension develops during pregnancy and is accompanied by severe signs that may pose risks to both mother and baby.
Gestational hypertension and PE without severe features: Hypertension developed during pregnancy but without additional severe signs.
Superimposed PE without severe features: Preeclampsia that develops in a woman who already had hypertension before pregnancy, but without additional severe signs.
Superimposed PE with severe features: Preeclampsia developed in a woman with pre-existing hypertension, accompanied by severe signs.
Suggested Interventions
The decision to interrupt the pregnancy is based on gestational age (GA) and the severity of hypertension:
Controlled CCH without antihypertensive: Interruption is suggested between 38 and 39 weeks.
Controlled CCH with antihypertensive: Interruption is recommended between 37 and 39 weeks.
Uncontrolled CCH: In this case, interruption should occur between 36 and 37 weeks.
Gestational hypertension and PE with severe features: Interruption should occur up to 34 weeks, and may be earlier if necessary, depending on the individual case.
Gestational hypertension and PE without severe features: Interruption from 37 weeks up to 37 weeks and 6 days.
Superimposed PE without severe features: Similar to gestational hypertension without severe features, interruption is suggested from 37 weeks.
Superimposed PE with severe features: Interruption should occur up to 34 weeks; before this period, the decision must be individualized.
Hypertension during pregnancy is a complex condition that requires a careful and individualized approach.
Proper management can significantly reduce the risks for both mother and baby.
These guidelines help ensure that each case is handled according to its severity, providing better outcomes for both.
It is essential that the medical team closely monitors each pregnant woman, adapting interventions according to the progression of the pregnancy and the specific needs of each patient.
