Pre-eclampsia differential diagnosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sara Zand, M.D.[2] Ogheneochuko Ajari, MB.BS, MS [3]
Overview
All of the hypertensive disorders during pregnancy including chronic hypertension, white coat hypertension, mask hypertension, gestational hypertension increase the risk of preeclampsia.
Differentiating Pre-eclampsia from other Diseases
| Differntiating diagnosis of hypertension in pregnancy | Chronic hypertension[1] | White coat[2] hypertension | Mask hypertension[3] | Gestational hypertension[4] | Preeclampsia |
|---|---|---|---|---|---|
| Onset | Before 20 weeks in pregnancy | Blood pressure ≥ 140/90 in office and clinic and BP < 135/85 at home | Normal blood pressure at office and elevation in other condition | Hypertension after 20 weeks of pregnancy with out proteinuria or hematologic abnormality | Hypertension after 20 weeks of pregnancy with proteinuria or maternal organ dysfunction |
| Management | Tightly controlling of hypertension (110-140/85), Fetal growth monitoring | Blood pressure monitoring | 24 hours ambulatory blood pressure monitoring | Tightly controlling Blood pressure | Tightly controlling Blood pressure |
| Prognosis | Increased risk of preeclampsia | Increased risk of preeclampsia | Increased risk of preeclampsia | Good prognosis,may 1/4 progress to preeclampsia | may progress to eclampsia or HELLP syndrome |
References
- ↑ Seely, Ellen W.; Ecker, Jeffrey (2014). "Chronic Hypertension in Pregnancy". Circulation. 129 (11): 1254–1261. doi:10.1161/CIRCULATIONAHA.113.003904. ISSN 0009-7322.
- ↑ Shahbazian N, Shahbazian H, Mohammadjafari R, Mousavi M (2013). "Ambulatory monitoring of blood pressure and pregnancy outcome in pregnant women with white coat hypertension in the third trimester of pregnancy". J Nephropharmacol. 2 (1): 5–9. PMC 5297468. PMID 28197434.
- ↑ Salazar MR, Espeche WG, Leiva Sisnieguez BC, Balbín E, Leiva Sisnieguez CE, Stavile RN, March CE, Grassi F, Santillan C, Cor S, Carbajal HA (November 2016). "Significance of masked and nocturnal hypertension in normotensive women coursing a high-risk pregnancy". J Hypertens. 34 (11): 2248–52. doi:10.1097/HJH.0000000000001067. PMID 27490952.
- ↑ Shen M, Smith GN, Rodger M, White RR, Walker MC, Wen SW (2017). "Comparison of risk factors and outcomes of gestational hypertension and pre-eclampsia". PLoS One. 12 (4): e0175914. doi:10.1371/journal.pone.0175914. PMC 5402970. PMID 28437461.