What is the main difference between gestational hypertension and preeclampsia?

High blood pressure during pregnancy is a condition that requires close monitoring, and there are two main types that may appear after the 20th week of pregnancy: gestational hypertension and preeclampsia. The primary difference between them lies in the presence of other signs of organ damage in preeclampsia, whereas gestational hypertension is limited to high blood pressure without these signs. Gestational hypertension is diagnosed when blood pressure exceeds 140/90 mmHg after the 20th week of pregnancy, typically returns to normal within 12 weeks after delivery, and often does not cause other symptoms [1].

What is preeclampsia?

Preeclampsia is a more serious condition than gestational hypertension, as it involves a sudden rise in blood pressure (140/90 mmHg or higher) after the 20th week of pregnancy, in addition to signs of damage to other organs such as the kidneys or liver [1]. One of the most prominent of these signs is the presence of excess protein in the urine [1]. Preeclampsia can be dangerous and life-threatening to both the mother and the fetus [1]. In some cases, preeclampsia may progress to eclampsia if it affects brain function, causing seizures or coma [1]. Preeclampsia can also occur after delivery, known as postpartum preeclampsia, and its symptoms may appear up to 6 weeks after delivery [1].

Danger signs requiring an emergency visit

It is very important to be aware of any signs that may indicate the development or worsening of preeclampsia, which require an immediate emergency visit. These signs include [1]:

• Severe headache that does not go away with regular painkillers.
• Vision problems, such as blurred vision or seeing spots.
• Pain in the upper right abdomen.
• Difficulty breathing.
• Sudden and severe swelling in the face and hands (although foot swelling is common in pregnancy, sudden swelling in other areas can be concerning) [1].
• Persistent nausea or vomiting [3].

If you have gestational hypertension, it is essential to be aware of these signs and seek urgent medical care if any of them appear, as this may indicate that the condition has progressed to preeclampsia [1].

The importance of regular monitoring

Regular blood pressure monitoring and urine analysis during prenatal visits are crucial for the early detection of any changes [1]. If blood pressure is 140/90 mmHg or higher, especially after the 20th week of pregnancy, the doctor may request additional tests, such as blood tests and urine tests to look for excess protein [1]. In some cases, the doctor may recommend taking a low dose of aspirin in the second trimester to reduce the risk of preeclampsia if you are at risk [3].

Next steps and emergency care

If you are diagnosed with gestational hypertension or preeclampsia, you and your baby will be closely monitored to reduce the chances of complications [1]. Treatment may include monitoring blood pressure at home, tracking fetal movement, adjusting physical activity, and taking medications to control blood pressure [1]. In severe cases of preeclampsia or if it progresses to severe eclampsia or HELLP syndrome, you may need to be admitted to the hospital, and the doctor may recommend early delivery [1]. The goal is to minimize risks to you while giving your baby as much time as possible to grow before birth [1]. For more information on this condition, you can visit Hypertension in Pregnancy: When Does It Become Preeclampsia and What Are the Danger Signs? (Arabic).

Medical references

• High Blood Pressure in Pregnancy
• High Blood Pressure During Pregnancy
• About Preeclampsia and Eclampsia