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"It has absolutely everything for medical school, so many histories with detailed differential diagnoses, how to approach emergencies, commonly prescribed drugs..every kind go examination you’ll ever need in osces"
John R 🇬🇧
"Thank you SO MUCH for the amazing educational resource. I’ve tried lots of platforms and books with mock OSCE stations and yours is by far and away the best I’ve tried"
Ed M 🇳🇿
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"Without a doubt, your platform outshines all other OSCE resources currently available. In all honesty, I can confidently attribute my success in securing a distinction in my finals to OSCEstop."
Harish K 🇬🇧
"OSCEstop distinguishes itself from many other platform banks by offering a wealth of questions that mimic the demanding and complex aspects of our finals. This platform played a crucial role in ensuring I was ready for the level of difficulty that awaited me in my final exams."
Gestational Hypertension is defined as the development of new-onset hypertension (blood pressure ≥ 140/90 mmHg) after 20 weeks of pregnancy in a woman previously normotensive, without the presence of proteinuria or other features of pre-eclampsia.
Epidemiology:
Affects approximately 6-17% of pregnant women.
It is one of the most common medical complications of pregnancy.
Risk Factors:
First pregnancy (nulliparity)
Multiple gestation (e.g., twins or triplets)
Family history of hypertension or pre-eclampsia
Advanced maternal age (>35 years)
Pre-existing medical conditions such as diabetes or kidney disease
Obesity
History of gestational hypertension or pre-eclampsia in a previous pregnancy
Pathophysiology:
The exact mechanism is not fully understood, but it is thought to involve abnormal placental development and function leading to impaired placental blood flow and resulting in systemic vascular resistance and hypertension.
Clinical Features
Signs and Symptoms:
Elevated blood pressure detected during prenatal visits, without additional signs of pre-eclampsia such as proteinuria or severe features.
May be asymptomatic, with hypertension detected only through routine antenatal care.
In some cases, women may report nonspecific symptoms such as headaches or changes in vision.
Diagnosis:
Blood pressure ≥ 140/90 mmHg on two separate occasions at least 4 hours apart, after 20 weeks of gestation, in a previously normotensive woman.
Absence of proteinuria or other systemic findings suggestive of pre-eclampsia.
Close monitoring of blood pressure and fetal well-being.
Lifestyle modifications, including dietary salt reduction and increased physical activity, may be recommended.
Antihypertensive medication may be considered in cases of severe hypertension (BP ≥ 160/110 mmHg) to prevent maternal complications, though the choice of medication must consider fetal safety.
Delivery:
The timing of delivery in gestational hypertension depends on the gestational age, control of blood pressure, and fetal condition.
Delivery is typically recommended at 37 weeks of gestation if blood pressure is controlled and there are no signs of fetal distress or pre-eclampsia.
Earlier delivery may be considered in cases of uncontrolled hypertension or if pre-eclampsia develops.
Postpartum Care:
Blood pressure typically returns to normal by 12 weeks postpartum. However, women with gestational hypertension are at increased risk of developing chronic hypertension and cardiovascular disease later in life.
Postpartum follow-up is important to ensure resolution of hypertension and to provide counseling on long-term cardiovascular risk reduction.
Complications
Progression to pre-eclampsia: A significant proportion of women with gestational hypertension may develop pre-eclampsia.
Increased risk of placental abruption, preterm delivery, and low birth weight.
Long-term, women with a history of gestational hypertension have an increased risk of chronic hypertension, type 2 diabetes, and cardiovascular disease.
Summary
Gestational Hypertension is a condition characterized by new-onset hypertension after 20 weeks of gestation without proteinuria or other systemic features of pre-eclampsia. It requires careful monitoring and management to prevent complications for both the mother and the fetus. Understanding the risk factors, pathophysiology, clinical management, and implications of gestational hypertension is crucial for medical students and healthcare professionals involved in obstetric care.