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 .