Hypertensive Disorder in Pregnancy- Pre-eclampsia
Tetiana Fiutek
Southwestern College
Sim Lab
Honorene Brown
April 5, 2021
, 1. What are the major differences between gestational hypertension, pre-
eclampsia, and eclampsia? What is the pathophysiology that leads to these
conditions?
Gestational hypertension: bood pressure (BP) 140/90 mmHg or systolic BP
increased 30mmHg or diastolic BP increased 15mmHg without proteinuria or edema.
After the delivery, BP goes back to normal pre- pregnancy level.
Pre-eclampsia: 1) without severe features: BP 140/90mmHg or systolic
elevated 30mmHg/ diastolic BP elevated 15mmHg; proteinuria 1+/2+ on a random
sample; weight gain over 2lb/weeks during the second trimester or 1lb/week in the
third trimester; mild edema in upper extremities or face. 2) with severe features:
BP 160/110mmHg; proteinuria of 3+/4+ on a random sample and 5g on a 24-hour
sample; oliguria; elevated serum creatinine; cerebral or visual disturbances; extensive
peripheral edema; pulmonary or cardiac involvement; hepatic dysfunction; epigastric
pain; thrombocytopenia.
Eclampsia: seizure or coma accompanied by signs and symptoms of
preeclampsia.
Gestational hypertension is condition in which a vasospasm occurs in small
and large arteries during pregnancy. It is most likely caused by the combination of the
increased cardiac output which damages the endothelial cells of the arteries, reduced
response of the body to prostaglandin vasodilator, and excess of thromboxane,
prostaglandin vasoconstrictor. All those factors lead to vasoconstriction and increase
in blood pressure.
At the beginning of the 20th week of gestation, all body systems are affected
by the vasospasm. The heart has to pump against an increasing peripheral resistance,
kidneys,liver, pancreas, brain, and placenta receive poor blood supply. Decreased