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Health Condition

Gestational Hypertension

About This Condition

Gestational hypertension (GH) is high blood pressure that develops after the twentieth week of pregnancy and returns to normal after delivery, in women with previously normal blood pressure.

GH may be an early sign of either preeclampsia or chronic hypertension. If these complications do not develop, or if chronic hypertension develops but remains mild, the outcome of pregnancy is usually good for both the mother and newborn. GH has been shown to occur more frequently in women who are obese1 or in those who are glucose-intolerant.2,3,4

Symptoms

Symptoms, which appear after the twentieth week of pregnancy, include swelling of the face and hands, visual disturbances, headache, high blood pressure, and a yellow discoloration of the skin and eyes.

Other Therapies

Treatment for GH includes bed rest, restriction of sodium intake, and, if necessary, hospitalization for observation. Intravenous magnesium solutions are occasionally recommended. The definitive treatment is termination of the pregnancy by induced delivery or cesarean section.

References

1. Ros JS, Cnattingius S, Lipworth L. Comparison of risk factors for preeclampsia and gestational hypertension in a population-based cohort study. Am J Epidemiol 1998;147:1062-70.

2. Caruso A, Ferrazzani S, De Carolis S, et al. Gestational hypertension but not pre-eclampsia is associated with insulin resistance syndrome characteristics. Hum Reprod 1999;14:219-23.

3. Innes KE, Wimsatt JH. Pregnancy-induced hypertension and insulin resistance: evidence for a connection. Acta Obstet Gynecol Scand 1999;78:263-84.

4. Solomon CG, Carroll JS, Okamura K, et al. Higher cholesterol and insulin levels in pregnancy are associated with increased risk for pregnancy-induced hypertension. Am J Hypertens 1999;12:276-82.

5. Leela R, Yasodhara P, Ramaraju MBBS, Ramaraju LA. Calcium and magnesium in pregnancy. Nutr Res 1991;11:1231-6.

6. Prada JA, Ross R, Clark KE. Hypocalcemia and pregnancy-induced hypertension produced by maternal fasting. Hypertension 1992;20:620-6.

7. Marcous S, Brisson J, Fabia J. Calcium intake from dairy products and supplements and the risk of preeclampsia and gestational hypertension. Am J Epidemiol 1991;133:1226-72.

8. Ortega RM, Martinez RM, Lopez-Sobaler AM, et al. Influence of calcium intake on gestational hypertension. Ann Nutr Metab 1999;43:37-46.

9. Bucher HC, Guyatt GH, Cook RJ, et al. Effect of calcium supplementation on pregnancy-induced hypertension and preeclampsia: a meta-analysis of randomized controlled trials. JAMA 1996;275:1113-7.

10. Lopez-Jaramillo P, Narvaez M, Weigle RM, Yepez R. Calcium supplementation reduces the risk of pregnancy-induced hypertension in an Andes population. Br J Obstet Gynaecol 1989;96:648-55.

11. Cong K, Chi S, Lui G. Calcium supplementation during pregnancy for reducing pregnancy induced hypertension. Chin Med J 1995;108:57-9.

12. Purwar M, Kulkarni, H, Motghare V, Dhole S. Calcium supplementation and prevention of pregnancy induced hypertension. J Obstet Gynaecol Res 1996;22:425-30.

13. Belizan JM, Villar J, Gonzalez L. Calcium supplementation to prevent hypertensive disorders of pregnancy. N Engl J Med 1991;325:1399-405.

14. Sanchez-Ramos L, Briones DK, Kaunitz AM, et al. Prevention of pregnancy-induced hypertension by calcium supplementation in angiotensin II-sensitive patients. Obstet Gynecol 1994;84:349-53.

15. Levine RJ, Hauth JC, Curet LB, et al. Trial of calcium to prevent preeclampsia. N Engl J Med 1997;337:69-76.

16. NIH Consensus Development Panel on Optimal Calcium Intake. Optimal calcium intake. Nutrition 1995;11:409-17.

17. Moutquin JM, Garner PR, Burrows RF, et al. Report of the Canadian Hypertension Society Consensus Conference: 2. Nonpharmacologic management and prevention of hypertensive disorders in pregnancy. CMAJ 1997;157:907-19.

18. Cong K, Chi S, Lui G. Calcium supplementation during pregnancy for reducing pregnancy induced hypertension. Chin Men J 1995;108:57-9.

19. Wynn A, Wynn M. Magnesium and other nutrient deficiencies as possible causes of hypertension and low birthweight. Nutr Health 1988;6:69-88.

20. Conradt A. Current concepts in the pathogenesis of gestosis with special reference to magnesium deficiency. Z Geburtshilfe Perinatol 1984;188:49-58 [review] [in German].

21. Leela R, Yasodhara P, Ramaraju MBBS, Ramaraju LA. Calcium and magnesium in pregnancy. Nutr Res 1991;11:1231-6.

22. Makrides M, Crowther CA. Magnesium supplementation in pregnancy. Cochrane Database Syst Rev 2000;2:CD000937 [review].

23. Li S, Tian H. Oral low-dose magnesium gluconate preventing pregnancy induced hypertension. Chung Hua Fu Chan Ko Tsa Chih 1997;32:613-5 [in Chinese].

24. D'Almeida A, Caretr JP, Anatol A, Prost C. Effects of a combination of evening primrose oil (gamma linolenic acid) and fish oil (eicosapentaenoic + docosahexaenoic acid) versus magnesium, and versus placebo in preventing pre-eclampsia. Women Health 1992;19:117-31.

25. Bullarbo M, Odman N, Nestler A, et al. Magnesium supplementation to prevent high blood pressure in pregnancy: a randomised placebo control trial. Arch Gynecol Obstet 2013;288:1269–74.

26. Rudnicki M, Frolich A, Rasmussen WF, McNair P. The effect of magnesium on maternal blood pressure in pregnancy-induced hypertension. A randomized double-blind placebo-controlled trial. Acta Obstet Gynecol Scand 1991;80:445-50.

27. Hunt IF, Murphy NJ, Cleaver AE, et al. Zinc supplementation during pregnancy: effects on selected blood constituents and on progress and outcome of pregnancy in low-income women of Mexican descent. Am J Clin Nutr 1984;40:508-21.

28. Popeski D, Ebbeling LR, Brown PB, et al. Blood pressure during pregnancy in Canadian Inuit: community differences related to diet. CMAJ 1991;145:445-54.

29. Franx A, Steegers EA, de Boo T, et al. Sodium-blood pressure interrelationship in pregnancy. J Hum Hypertens 1999;13:159-66.

30. van der Maten GD. Low sodium diet in pregnancy: effects on maternal nutritional status. Eur J Obstet Gynecol Reprod Biol 1995;61:63-4.

31. Steegers EA, Van Lakwijk HP, Jongsma HW, et al. (Patho)physiological implications of chronic dietary sodium restriction during pregnancy; a longitudinal prospective randomized study. Br J Obstet Gynaecol 1991;98:980-7.

32. Moutquin JM, Garner PR, Burrows RF, et al. Report of the Canadian Hypertension Society Consensus Conference: 2. Nonpharmacologic management and prevention of hypertensive disorders in pregnancy. CMAJ 1997;157:907-19.

33. Mounier-Vehier C, Equine O, Valat-Rigot AS, et al. Hypertensive syndromes in pregnancy. Physiopathology, definition and fetomaternal complications. Presse Med 1999;28:880-5 [in French].

34. Mounier-Vehier C, Equine O, Valat-Rigot AS, et al. Hypertensive syndromes in pregnancy. Diagnosis and therapy. Presse Med 1999;28:886-91 [in French].

35. Jerie P. Hypertension and its treatment in pregnancy. Cas Lek Cesk 1998;137:467-72 [review] [in Czech].

36. Wergeland E, Strand K. Work pace control and pregnancy health in a population-based sample of employed women in Norway. Scand J Work Environ Health 1998;24:206-12.

37. Marcoux S, Berube S, Brisson C, Mondor M. Job strain and pregnancy-induced hypertension. Epidemiology 1999;10:376-82.

38. Goldenberg RL, Cliver SP, Bronstein J, et al. Bed rest in pregnancy. Obstet Gynecol 1994;84:131-6 [review].

39. Herrera JA. Nutritional factors and rest reduce pregnancy-induced hypertension and pre-eclampsia in positive roll-over test primigravidas. Int J Gynaecol Obstet 1993;41:31-5.

40. Mathews DD. A randomized controlled trial of bed rest and sedation or normal activity and non-sedation in the management of non-albuminuric hypertension in late pregnancy. Br J Obstet Gynaecol 1997;84:108-14.

41. Crowther CA, Bouwmeester AM, Ashurst HM. Does admission to hospital for bed rest prevent disease progression or improve fetal outcome in pregnancy complicated by non-proteinuric hypertension? Br J Obstet Gynaecol 1992;99:13-7.

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The information presented by Healthnotes is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. Self-treatment is not recommended for life-threatening conditions that require medical treatment under a doctor's care. For many of the conditions discussed, treatment with prescription or over the counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications. Information expires December 2018.