![]() ![]() ![]() De novo hypertension after 20 weeks’ gestation accompanied by at least one of the following: Hypertension that appears de novo after 20 weeks’ gestation and normalizes after pregnancy. Hypertension discovered preconception or prior to 20 weeks’ gestation. Accepted across international guidelines are the following four categories: 3 – 10Ĭhronic/pre-existing hypertension. Specific hypertensive disorders of pregnancy are named based on the context in which the hypertension is first identified ( Table 1). 12 Both the European Society of Cardiology (ESC) and Hypertension Canada, whose task forces also published guidelines for the management of cardiovascular diseases during pregnancy since the AHA/ACC recommendations changed in 2017, have also not changed their diagnostic criteria. Of note, the American College of Obstetricians and Gynecologists (ACOG) acknowledged in the newly released recommendations 3, 12 that its hypertension definitions conflict with the recently changed diagnostic criteria of the American College of Cardiology (ACC) and American Heart Association (AHA) (stage I hypertension 130–139/80–89 mmHg stage 2 ⩾ 140/90 mmHg), 16 but have not yet redefined their diagnostic criteria. 14 Severe hypertension in pregnancy has lower thresholds than in non-pregnant adults because pregnant women are known to develop hypertensive encephalopathy at lower blood pressures. Sometimes this category as a whole is termed “mild,” or it is further broken down into mild (140–149/90–99 mmHg) and moderate (150–159/100–109 mmHg). Any values between SBP 140–159 mmHg and DBP 90–109 mmHg. SBP ⩾ 140 mmHg and/or DBP ⩾ 90 mmHg measured several hours apartīP: blood pressure SBP: systolic blood pressure DBP: diastolic blood pressure HELLP: hemolysis, elevated liver enzymes, low platelet count. SBP ⩾ 160 mmHg and/or DBP ⩾ 110 mmHg, confirmed within 15 min SBP ⩾ 140 mmHg and/or DBP ⩾ 90 mmHg, confirmed over a few hours SBP ⩾ 140 mmHg and/or DBP ⩾ 90 mmHg, measured at least 15 min apart SBP ⩾ 160 mmHg and/or DBP ⩾ 110 mmHg, measured at least 4 h apart SBP ⩾ 140 mmHg and/or DBP ⩾ 90 mmHg, measured at least 4 h apart Preeclampsia superimposed on chronic hypertension Preeclampsia – de novo or superimposed on chronic hypertension ![]() Pre-existing hypertension plus superimposed gestational hypertension with proteinuria Preeclampsia (includes non-severe preeclampsia, severe preeclampsia, HELLP syndrome, eclampsia) Royal College of Obstetricians and Gynaecologists (RCOG) 10Ĭhronic hypertension with superimposed preeclampsia Society of Obstetric Medicine of Australia and New Zealand (SOMANZ) 9 ![]() International Society for the Study of Hypertension in Pregnancy (ISSHP) 7, 8 Society of Obstetricians and Gynaecologists of Canada (SOGC) 6 American College of Obstetricians and Gynecologists (ACOG) 3 ![]()
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