Hypertensive disorders of pregnancy include 1) new onset
in pregnancy (preeclampsia or gestational hypertension), 2)
preexisting hypertension, and 3) exacerbation of preexisting
hypertension (superimposed preeclampsia; Table 1) (1).
New-onset hypertension develops during the second half of
pregnancy (usually in the third trimester) in 3–5% of women
who were previously normotensive. In these women, hypertension
typically resolves within 6 wk postpartum, although
they may be predisposed to later essential hypertension.
Preeclampsia is a systemic syndrome whose
hallmark is proteinuria (300 mg protein or more over 24 h).
Other systemic manifestations include disseminated intravascular
coagulation, hemolysis, elevated liver function
tests, and, rarely, seizures (eclampsia); delivery is the only
definitive treatment. Gestational hypertension, a generally
more benign disorder, is diagnosed when blood pressure is
elevated in the absence of these findings. When other systemic
manifestations of disease are absent, the distinction
between preeclampsia and gestational hypertension is made