Hypertensive Disorders of Pregnancy

Aka: Hypertensive Disorders of Pregnancy, Hypertension in Pregnancy, Pregnancy Related Hypertension, Pregnancy Induced Hypertension, Hypertension Induced by Pregnancy, Gestational Hypertension-Preeclampsia, Preeclampsia, PIH, EPH gestosis, Pre-Eclampsia

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II. Definitions

  1. Chronic Hypertension
    1. Consistently elevated Blood Pressures presenting at any time, but does not resolve after pregnancy
  2. Gestational Hypertension
    1. New onset Hypertension after 20 weeks gestation, WITHOUT Proteinuria or end-organ dysfunction
  3. Preeclampsia
    1. New onset Hypertension onset after 20 weeks gestation, WITH Proteinuria or end-organ dysfunction
    2. Previously known as EPH gestosis (edema, Proteinuria, Hypertension) or Toxemia of Pregnancy
  4. Preeclampsia With Severe Features
    1. Gestational Hypertension or Preeclampsia AND
    2. End organ injury OR severe range Hypertension (SBP>160 or DBP>110 mmHg on two readings)
      1. See signs below regarding end organ injury criteria
  5. Superimposed Preeclampsia
    1. Chronic Hypertension AND
    2. Proteinuria OR severe features
  6. HELLP Syndrome
    1. Severe Preeclampsia AND
    2. Hemolysis, Elevated Liver enzymes and Low Platelets
  7. Eclampsia
    1. New onset Generalized Tonic Clonic Seizure, multifocal or Focal Seizure AND
    2. Pregnant or postpartum (within 6 weeks) AND
    3. Hypertensive Disorder in Pregnancy AND
    4. No alternative diagnosis for Seizure

III. Epidemiology

  1. Incidence
    1. All pregnancies with Preeclampsia or Eclampsia: 4-5%
    2. Hypertensive Disorders of Pregnancy overall (including chronic Hypertension): 14%
    3. Preterm births: 20%
  2. Mortality: 100,000 maternal deaths per year worldwide
    1. Accounts for 10-30% of all maternal deaths yearly

IV. Pathophysiology

  1. Increased Vascular Resistance
    1. Appears to result from endothelial cell dysfunction
    2. Increased resistance to placental Blood Flow with placenta hypoperfusion and chronic placenta ischemia
  2. Endothelial Cell dysfunction
    1. Very active organ system (not just vessel lining)
    2. Surface Area >6300 square meters over 100g of tissue
    3. Associated findings
      1. Edema
      2. Proteinuria
  3. Imbalance of vasoactive substances
    1. Imbalance between Thromboxane and prostacyclin (may be mechanism for Aspirin activity in PIH)
  4. Cardiovascular Effects
    1. Hypertension
    2. Arterial thickening
    3. Left ventricular wall thickening and Diastolic Dysfunction
  5. Decreased Intravascular volume
    1. Hemoconcentrated
    2. Increased Hemoglobin
  6. Coagulation abnormalities
    1. See HELLP Syndrome
  7. Multiple system effects by oxygen free radicals
    1. Perfusion and re-perfusion injury
    2. Lipid peroxidation
    3. Antioxidant mechanisms are protective
  8. Trophoblastic Invasion
    1. Two phases
      1. First: Decidua (abnormal placental implantation)
      2. Second: 12-18 weeks gestation
    2. Effects of PIH are reversed with Trophoblast delivery
  9. Model System
    1. Pregnant ewes
    2. Used to study Prostaglandin synthesis inhibitor
  10. Hypertension is a major mental roadblock
    1. Prevents understanding and treatment of toxemia
    2. Hypertension is an effect of PIH, not a cause

V. Classification

  1. Pregnancy Induced Hypertension (PIH)
    1. Hypertension without Proteinuria or pathologic edema (Gestational Hypertension)
      1. Up to 50% will develop Preeclampsia
      2. Gestational Hypertension with Severe Features risks the same complications as Preeclampsia
    2. Preeclampsia with Proteinuria or pathologic edema
      1. Mild Preeclampsia
      2. Severe Preeclampsia
    3. Eclampsia
      1. Convulsions
      2. Proteinuria
      3. Edema
    4. HELLP Syndrome (complicates 15% of Preeclampsia cases, associated with 30% mortality)
      1. Hemolysis
      2. Elevated Liver Function Tests
      3. Low Platelets
  2. Coincidental Hypertension
    1. Chronic Hypertension
      1. See Chronic Hypertension in Pregnancy
      2. Hypertension onset before 20 weeks gestation, or persisting >12 weeks after delivery
    2. Pregnancy Aggravated Chronic Hypertension
      1. Superimposed Preeclampsia
      2. Superimposed Eclampsia

VI. Risk Factors

  1. Antiphospholipid Antibody Syndrome (RR 10)
  2. Prior history of Preeclampsia in prior pregnancy, esp. if prior to 32 weeks (RR 7)
  3. Non-hispanic black women (RR 5, compared with non-hispanic white women)
  4. Diabetes Mellitus (RR 3)
  5. Family History of Preeclampsia in first degree relative (25% of cases, RR 3)
  6. Multiple Gestation (RR 3)
  7. Primigravid (nulliparity) or new paternity (RR 3)
  8. Obesity (RR 2)
  9. Maternal age >40 years (RR 1.6)
  10. Preexisting Chronic Hypertension
  11. Angiotensin gene T235
  12. Hydatiform mole
  13. Fetal hydrops
  14. Chronic Kidney Disease
  15. Duckitt (2005) BMJ 330(7491): 565 [PubMed]

VII. Symptoms: Onset after 20 weeks gestation (and up to 6 weeks postpartum)

  1. Malaise
  2. Hand and face edema
    1. Least reliable PIH indicator
    2. Absent in 33% of PIH cases
    3. Often present in healthy third trimester pregnancies
  3. Headache
  4. Visual disturbance
  5. Epigastric Pain

VIII. Signs: General

  1. Excessive weight gain
  2. Hyperreflexia and Clonus
  3. Blood Pressure
    1. Assumes normal Blood Pressure before pregnancy
    2. Based on two supine Blood Pressures, 4-6 hours apart
    3. Mild Preeclampsia
      1. Blood Pressure greater than or equal to 140/90
      2. Prior guideline: Relative BP increase 30/15
        1. NHLBI Working Group does not recommend using due to high False Positive Rate
        2. Use 140/90 cutoff for all pregnant patients
    4. Severe Preeclampsia
      1. Blood Pressure exceeds 160/110
      2. Start Antihypertensives if systolic Blood Pressure >160 or diastolic Blood Pressure >110 for >15 minutes
      3. See Severe Hypertension Management in Pregnancy

IX. Signs: Preeclampsia With Severe Features (End Organ Injury)

  1. Blood Pressure > 160/110 mmHg
    1. Based on two values >=4 hours apart (with either SBP or DBP elevated above criteria)
  2. Proteinuria >5 grams per 24 hours (see labs below)
  3. Urine Output decreased
    1. Urine Output less than 500 ml in 24 hours
  4. Increased Serum Creatinine >1.1 (or >2x baseline)
  5. Thrombocytopenia (Platelet Count <100k)
  6. Right upper quadrant or Epigastric Pain (seen in HELLP Syndrome)
  7. Pulmonary Edema
  8. Increased hepatic transaminases (>2 fold over baseline)
  9. New Headache or Vision change
  10. Altered Mental Status

X. Labs: Urine

  1. Proteinuria is not a useful screening measure and is NOT required for Severe Preeclampsia diagnosis
    1. Proteinuria is a late finding
    2. Rely on BP and other measures for screening
    3. Proteinuria assesses degree of Pre-Eclampsia
  2. Urine Protein and 24 Hour Urine Protein
    1. Non-Proteinuric Hypertension in Pregnancy
      1. Trace or no Urine Protein present
    2. Mild Preeclampsia
      1. Urine chemstrip 2+ Protein or greater (>=0.3 g/liter)
        1. Based on 2 random urines >6 hours apart
      2. Urine Protein exceeds 300 mg in 24 hours (or Urine Protein to Creatinine Ratio >0.3)
    3. Severe Preeclampsia
      1. Urine chemstrip exceeds 3+ Protein (2 random urine samples >6 hours apart)
      2. Urine Protein exceeds 5 grams in 24 hours
  3. Urine for single Specimen Protein to Creatinine ratio
    1. Correlates with 24 Hour Urine Protein
    2. Positive if Urine Protein to Creatinine Ratio >0.3
    3. PIH unlikely if Protein to Creatinine ratio < 0.19
      1. Negative Predictive Value: 83%
    4. Consider confirmation of abnormal tests with 24 hour urine
    5. References
      1. Wheeler (2007) Am J Obstet Gynecol 196(5): 465 [PubMed]
      2. Young (1996) J Fam Pract 42:385-9 [PubMed]

XI. Labs: Blood

  1. Complete Blood Count with Platelets
    1. Thrombocytopenia seen in Severe Preeclampsia
  2. Serum Electrolytes
  3. Serum Creatinine (>1.1 in Severe Preeclampsia)
    1. Reduced GFR may progress to Acute Renal Failure
  4. Uric Acid
  5. Liver Function Tests (elevated transaminases)
    1. Aspartate Aminotransferase
    2. Alanine Aminotransferase
    3. Serum Bilirubin
    4. Serum Albumin
    5. Lactic Acid dehydrogenase
  6. Coagulation Studies for Severe Preeclampsia or HELLP
    1. ProTime (PT)
    2. Partial Thromboplastin Time (aPTT)
    3. Fibrin split products (Fibrin Degradation Products)
    4. Fibrinogen

XII. Diagnostics: Fetus

  1. Fetal Nonstress Test
  2. Obstetric Ultrasound
    1. Biophysical Profile
    2. Amniocentesis for Fetal Lung Maturity when indicated

XIII. Diagnosis: Preeclampsia ACOG Criteria

  1. Gestation >=20 weeks (or postpartum up to 6 weeks)
  2. Hypertension (and previously normal Blood Pressure)
    1. Systolic Blood Pressure >=140 or Diastolic Blood Pressure >= 90 (on 2 occasions at least 4 hours apart) OR
    2. Systolic Blood Pressure >=160 or Diastolic Blood Pressure >= 110 (confirmed on at least one BP recheck)
  3. Proteinuria
    1. Urine Dipstick Protein 1+ or greater OR
    2. Protein to Creatinine ratio >= 0.3 mg/dl
    3. 24 Hour Urine Protein > 300 mg/day
  4. Alternative diagnostic criteria if Proteinuria absent (at least one present)
    1. Thrombocytopenia (Platelet Count <100k)
    2. Serum Creatinine >1.1 mg/dl (or doubling of Serum Creatinine)
    3. Elevated Liver Function Tests with right upper quadrant pain or refractory Epigastric Pain
      1. Elevated Liver Function Tests typically with serum transaminases at least double normal level
    4. Pulmonary Edema
    5. Cerebral or visual symptoms
  5. Tests that NOT recommended for diagnosis (per ACOG)
    1. sFIT-1/PIGF Ratio
      1. Low accuracy for Preeclampsia (Test Sensitivity 78%, Test Specificity 84%) in 2024
      2. Placental growth factor (PIGF) triggers Vasoconstriction, endothelial damage and may contribute to Preeclampsia
      3. Soluble FMS-Like Tyrosine Kinase-1 (sFIT-1) is a Vascular Endothelial Growth Factor, that inhibits PIGF
      4. Lala (2024) Am Fam Physician 109(5): 470-1 [PubMed]
  6. Resources
    1. ACOG Hypertension in Pregnancy
      1. http://www.acog.org/Resources-And-Publications/Task-Force-and-Work-Group-Reports/Hypertension-in-Pregnancy

XIV. Monitoring

  1. See Gestational Hypertension (chronic Hypertension)
  2. See Mild Preeclampsia
  3. See Severe Preeclampsia
  4. See HELLP Syndrome

XV. Management

  1. See Delivery Indications in PIH
  2. See Gestational Hypertension Management
  3. See Mild PIH Management
  4. See Severe PIH Management
  5. See Eclampsia
  6. See HELLP Syndrome
  7. See PIH Blood Pressure Management
  8. See PIH Seizure Prophylaxis

XVI. Prevention

  1. See PIH Prophylaxis

XVII. Complications: Maternal

  1. Eclampsia
  2. Left Ventricular Dysfunction
  3. Placental Abruption
  4. Coronary Artery Disease
  5. Chronic Hypertension
  6. Cerebrovascular Accident
  7. Cerebrovascular Accident in Women
    1. See Cerebrovascular Accident Risk in Women

XVIII. Complications: Fetus and Infant

  1. Neonatal Asphyxia
  2. Neonatal Hypoglycemia
  3. Intrauterine Growth Retardation (low birth weight)
  4. Perinatal mortality
  5. Congenital Malformations
  6. Cognitive deficits and Developmental Disability
  7. Increased Cardiovascular Risk longterm (chronic Hypertension, Obesity, cardiovascular disease)

XIX. Course: Postpartum

  1. Observe postpartum for 72 hours inpatient or with close home monitoring
  2. PIH may have onset up to 6 weeks postpartum (even without antepartum PIH)
    1. More than 90% of cases present within 7 days of delivery (esp. first 48 hours)
    2. Consider retained products of conception in Postpartum Hypertension differential diagnosis
  3. Most PIH cases improve in first 1-2 days after delivery
    1. Blood Pressure decreases
    2. Diuresis
  4. Eclampsia may occur after delivery (usually <24-48 hours)
    1. Up to 20% of Eclamptic Seizures present postpartum (15% of these cases were without prior PIH diagnosis)
    2. Continue Magnesium Sulfate for 12-24 hours after delivery
    3. Continue to follow Blood Pressure and Urine Output
    4. Observe for signs of HELLP Syndrome
  5. Hypertension
    1. See Blood Pressure Management in Pregnancy for protocol and Antihypertensive indications
    2. Anticipate increased Blood Pressure in the first few days after delivery (due to fluid redistribution)
    3. Hypertension remits by 6-12 weeks postpartum
  6. Other measures
    1. Counsel women on prevention of cardiovascular disease (e.g. Tobacco Cessation, Hyperlipidemia, Exercise)

XX. Prognosis

  1. Isolated Preeclampsia risks outside of pregnancy
    1. Confers future risk of Hypertension, vascular disease
    2. Wilson (2003) BMJ 326:845-9 [PubMed]
  2. Increased risk of Preeclampsia in future pregnancies
    1. All women with history of Preeclampsia
    2. Onset before 30 weeks gestation (40% recurrence risk)
    3. Black race
    4. Different father than prior gestation
    5. Preeclampsia previously in Multiparous patient

XXI. Prevention

  1. See Pregnancy Induced Hypertension Prophylaxis

XXII. References

  1. Marlow (2021) Crit Dec Emerg Med 35(2): 19-23
  2. (2000) Am J Obstet Gynecol 183(1):S1-22 [PubMed]
  3. Farahi (2024) Am Fam Physician 109(3): 251-60 [PubMed]
  4. Leeman (2008) Am Fam Physician 78:93-100 [PubMed]
  5. Leeman (2016) Am Fam Physician 93(2):121-7 [PubMed]
  6. Sibai (2003) Obstet Gynecol 102:181-92 [PubMed]
  7. Zamorski (2001) Am Fam Physician 64(2): 263-70 [PubMed]

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Related Studies

Ontology: Pre-Eclampsia (C0032914)

Definition (CHV) A condition of hypertension occurring in pregnancy
Definition (CHV) A condition of hypertension occurring in pregnancy
Definition (CHV) A condition of hypertension occurring in pregnancy
Definition (NCI) A systolic blood pressure of 140 mmHg or higher, or a diastolic blood pressure of 90 mmHg or higher on two occasions at least 4 hours apart (or greater than or equal to 160/110 mmHg within a short interval) after 20 weeks of gestation in a woman with previously normal blood pressure. It may present with proteinuria but if not, it may be associated with thrombocytopenia, impaired liver function, progressive renal insufficiency, pulmonary edema, or new-onset cerebral or visual disturbances.(NICHD)
Definition (NCI) A pregnancy induced hypertensive state that occurs after 20 weeks of gestation characterized by an increase in blood pressure, along with body swelling and proteinuria.
Definition (MSH) A complication of PREGNANCY, characterized by a complex of symptoms including maternal HYPERTENSION and PROTEINURIA with or without pathological EDEMA. Symptoms may range between mild and severe. Pre-eclampsia usually occurs after the 20th week of gestation, but may develop before this time in the presence of trophoblastic disease.
Definition (CSP) pregnancy induced hypertensive states, including EPH gestosis when edema and proteinuria accompany hypertension; other hypertensive disorders that develop during pregnancy or the puerperium are preeclampsia and eclampsia, either of which may be superimposed upon chronic hypertensive vascular or renal disease.
Definition (CSP) toxemia occurring in women in the second half of their pregnancy, characterized by hypertension, and usually by edema and proteinuria, but without the convulsions and coma associated with eclampsia.
Concepts Pathologic Function (T046)
MSH D011225
ICD10 O14.9 , O14.90, O14
SnomedCT 6758009, 398254007, 198972006, 156109003, 288201007, 237280005, 267306006, 199011002, 156106005, 198979002, 15394000, 46764007
English Pre Eclampsia, Preeclampsia, EPH - Edema/prot/hyper, preg, EPH - Oedema/prot/hyper, preg, Prot hypertension of pregnancy, Toxaemia NOS, Pre-eclampsia, unspecified, PREG1, TOXEMIA OF PREGNANCY, PREECLAMPSIA/ECLAMPSIA 1, PEE1, PEE, PREGN TOXEMIAS, PRE-ECLAMPSIA, PREECLAMPSIA, toxemia of pregnancy (diagnosis), pre-eclampsia, pre-eclampsia (diagnosis), toxemia of pregnancy, Pre-eclampsia toxemia, Unspecified pre-eclampsia, unspecified trimester, Unspecified pre-eclampsia, Pre-Eclampsia [Disease/Finding], eph gestosis, toxemia pregnancy, preeclampsia, toxaemia pregnancy, Toxaemia (in);pregnancy, maternal toxemia, pregnancy toxaemia, toxemia, pre eclampsia, pregnancy toxemias, pregnancy toxemia/hypertension, pregnancy toxemia, Toxemia Of Pregnancy, Preeclampsia/Eclampsia 1, Pre-eclampsia NOS (disorder), Toxemia NOS (disorder), Proteinuric hypertension of pregnancy (disorder), Pre-eclampsia toxaemia, Toxemia, Toxemia of pregnancy, Pre-eclampsia, EPH - Edema, proteinuria and hypertension of pregnancy, EPH - Oedema, proteinuria and hypertension of pregnancy, Proteinuric hypertension of pregnancy, PE - Pre-eclampsia, PET - Pre-eclamptic toxaemia, PET - Pre-eclamptic toxemia, Pre-eclamptic toxaemia, Pre-eclamptic toxemia, Toxaemia of pregnancy, Pre-eclampsia (disorder), Toxemia of pregnancy (disorder), maternal; toxemia, pre-eclamptic; toxemia, pregnancy; pre-eclampsia, pregnancy; toxemia, toxemia; maternal, toxemia; pre-eclamptic, toxemia; pregnancy, Pre-eclampsia, NOS, Pre-eclamptic toxemia, NOS, Toxemia of pregnancy, NOS, Toxaemia of pregnancy, NOS, Edema Proteinuria Hypertension Gestosis, Edema-Proteinuria-Hypertension Gestosis, EPH Complex, EPH Gestosis, EPH Toxemia, EPH Toxemias, Gestosis, Edema-Proteinuria-Hypertension, Gestosis, EPH, Gestosis, Hypertension-Edema-Proteinuria, Gestosis, Proteinuria-Edema-Hypertension, Hypertension Edema Proteinuria Gestosis, Hypertension-Edema-Proteinuria Gestosis, Pregnancy Toxemia, Pregnancy Toxemias, Proteinuria Edema Hypertension Gestosis, Proteinuria-Edema-Hypertension Gestosis, Toxemia, EPH, Toxemia, Pregnancy, Toxemias, EPH, Toxemias, Pregnancy, Pre-Eclampsia, Toxemia of Pregnancy, Toxemia NOS, Pre-eclampsia NOS, Pre-eclamptic NOS, Toxemia (in);pregnancy, toxemia in pregnancy, toxaemia in pregnancy
Portuguese PRE-ECLAMPSIA, Toxemia pré-eclâmptica, Toxemia da gravidez, Gestose, Toxemia Gravídica, Pré-eclampsia, Pré-Eclâmpsia, Toxemias Gravídicas
Dutch zwangerschapvergiftiging, pre-eclamptische toxicose, zwangerschapstoxicose, pre-eclampsie toxemie, Zwangerschapstoxicose, maternaal; toxemie, preëclamptisch; toxemie, toxemie; preëclamptisch, toxemie; van moeder, toxemie; zwangerschap, zwangerschap; preëclampsie, zwangerschap; toxemie, Preëclampsie, niet gespecificeerd, pre-eclampsie, Preëclampsie, Vergiftiging, zwangerschaps-
French Toxémie prééclamptique, PRE-ECLAMPSIE, Toxémie pré-éclamptique, Pré-éclampsie, Prééclampsie, Toxémie gravidique, Éclampsisme
German Toxaemie bei Praeeklampsie, Toxaemie waehrend Schwangerschaft, Praeeklampsie, nicht naeher bezeichnet, Praeeklampsie, Präeklampsie
Italian Tossiemia pre-eclamptica, EPH-gestosi, Gestosi con edema, proteinuria e ipertensione, Tossiemia gravidica, Preeclampsia, Pre-eclampsia
Spanish Toxemia del embarazo, Toxemia preeclampsica, Toxemia preeclámpsica, preeclamsia, preeclamsia (trastorno), preeclampsia (trastorno), edema, proteinuria e hipertensión durante el embarazo, preeclampsia, toxemia, SAI (trastorno), pre - eclampsia, toxemia preeclámpsica, preeclampsia, SAI (trastorno), preeclampsia, SAI, Pre-eclampsia NOS, toxemia, SAI, edema, proteinuria e hipertensión gestacional, Gestosis, preeclampsia (concepto no activo), toxemia del embarazo (trastorno), toxemia del embarazo, toxemia gravídica, Preeclampsia, Toxemias del Embarazo
Japanese 妊娠中毒症, ﾆﾝｼﾝﾁｭｳﾄﾞｸｼｮｳ, ｼｶﾝｾﾞﾝｼｮｳ, 晩期妊娠中毒症, 高血圧浮腫蛋白尿妊娠中毒症, 妊娠中毒症-晩期, 妊娠中毒症-EPH, 蛋白尿浮腫高血圧妊娠中毒症, 浮腫蛋白尿高血圧妊娠中毒症, EPH妊娠中毒症, 子かん前症, ｼｶﾝｾﾞﾝｼｮｳｾｲﾁｭｳﾄﾞｸｼｮｳ, 子癇前症性中毒症, 妊娠中毒症-重症, 子癇前症, 類子癇症, 重症妊娠中毒症
Czech preeklampsie, Preeklamptická toxemie, Těhotenská toxemie, Preeklampsie, EPH gestóza, pozdní gestóza
Finnish Pre-eklampsia
Russian PREEKLAMPSIIA, TOKSIKOZ BEREMENNOSTI S OTEKOM, PROTEINURIEI, GIPERTONIEI, GIPERTONIIA-OTEK-PROTEINURIIA PRI TOKSIKOZE BEREMENNYKH, GESTOZ, OPG, PROTEINURIIA-OTEK-GIPERTONIIA PRI TOKSIKOZE BEREMENNYKH, BEREMENNOSTI TOKSIKOZ, OPG, BEREMENNOSTI TOKSIKOZY, OPG TOKSIKOZ BEREMENNOSTI, БЕРЕМЕННОСТИ ТОКСИКОЗ, ОПГ, БЕРЕМЕННОСТИ ТОКСИКОЗЫ, ГЕСТОЗ, ОПГ, ГИПЕРТОНИЯ-ОТЕК-ПРОТЕИНУРИЯ ПРИ ТОКСИКОЗЕ БЕРЕМЕННЫХ, ПРЕЭКЛАМПСИЯ, ПРОТЕИНУРИЯ-ОТЕК-ГИПЕРТОНИЯ ПРИ ТОКСИКОЗЕ БЕРЕМЕННЫХ, ОПГ ТОКСИКОЗ БЕРЕМЕННОСТИ, ТОКСИКОЗ БЕРЕМЕННОСТИ С ОТЕКОМ, ПРОТЕИНУРИЕЙ, ГИПЕРТОНИЕЙ
Swedish Havandeskapsförgiftning
Korean 상세불명의 전자간증
Croatian PREEKLAMPSIJA, PREDEKLAMPSIJA, PRIJETEĆA EKLAMPSIJA
Polish Stan przedrzucawkowy, Zatrucie ciążowe, Gestoza EPH
Hungarian Praeeclampsiás toxaemia, Prae-eclampsia, Terhességi toxaemia, Pre-eclampsiás toxaemia
Norwegian Svangerskapsforgiftning, Preeklampsi, Graviditetsforgiftning, Graviditetstoksikose, Svangerskapstoksikose, Toxemia gravidarum
Derived from the NIH UMLS (Unified Medical Language System)

Ontology: Hypertension induced by pregnancy (C0340274)

Definition (NCI) A blood pressure elevation after 20 weeks of gestation in the absence of either proteinuria or systemic findings like thrombocytopenia, impaired liver function, progressive renal insufficiency, pulmonary edema or the new-onset of cerebral or visual disturbances.(NICHD)
Definition (MSH) A condition in pregnant women with elevated systolic (>140 mm Hg) and diastolic (>90 mm Hg) blood pressure on at least two occasions 6 h apart. HYPERTENSION complicates 8-10% of all pregnancies, generally after 20 weeks of gestation. Gestational hypertension can be divided into several broad categories according to the complexity and associated symptoms, such as EDEMA; PROTEINURIA; SEIZURES; abnormalities in BLOOD COAGULATION and liver functions.
Concepts Pathologic Function (T046)
MSH D046110
ICD10 O13
SnomedCT 156106005, 156112000, 198969004, 267307002, 267306006, 308551004, 48194001, 30354006
LNC LA19981-2
English H/T - pregnancy, Hypertension induced by pregnancy, HYPERTENSION, PREGNANCY-INDUCED, HYPERTENSION PREGN IND, Hypertension of pregnancy NOS, pregnancy-induced hypertension, pregnancy-induced hypertension (diagnosis), PIH - Preg-ind hypertension, Induced Hypertension, Pregnancy, Pregnancy Induced Hypertension, Induced Hypertensions, Pregnancy, Hypertensions, Pregnancy Induced, gestational hypertension NOS, Hypertension, Pregnancy-Induced [Disease/Finding], PIH Pregnancy induced hypertension, Pregnancy induced hypertension, high blood pressure disorder caused by pregnancy, high blood pressure caused by pregnancy, hypertension in pregnancy, pregnancy induced hypertension, gestational hypertension, Hypertension of pregnancy, Hypertension induced by pregnancy (disorder), Hypertension of preg., Hypertension of pregnancy NOS (disorder), Pregnancy-Induced Hypertension, Hypertension gestational, Gestational hypertension, GH - Gestational hypertension, PIH - Pregnancy-induced hypertension, Gestational hypertension (disorder), Pregnancy-induced hypertension (disorder), Pregnancy-induced hypertension, pregnancy; hypertension, Pregnancy-induced hypertension, NOS, Gestational Hypertension, Hypertension, Gestational, Hypertension, Pregnancy Induced, Hypertension, Pregnancy-Induced, Pregnancy Associated Hypertension
Swedish Graviditetshypertoni
Czech hypertenze indukovaná těhotenstvím, Těhotenstvím indukovaná hypertenze, Gestační hypertenze
Spanish Hipertensión Inducida en el Embarazo, Hipertensión inducida por el embarazo, Hipertensión gestacional, hipertensión durante el embarazo, SAI, hipertensión durante el embarazo, SAI (trastorno), Hypertension of pregnancy NOS, Hipertensión Gestacional, hipertensión gestacional (trastorno), hipertensión gestacional, hipertensión gestacional [dup] (trastorno), hipertensión inducida por el embarazo, hipertensión inducida por el embarazo (trastorno)
Finnish Raskauteen liittyvä kohonnut verenpaine
Russian GIPERTENZIIA, VYZVANNAIA BEREMENNOST'IU, ГИПЕРТЕНЗИЯ, ВЫЗВАННАЯ БЕРЕМЕННОСТЬЮ
Japanese 妊娠中毒症, 妊娠中毒, 妊娠高血圧, 妊娠誘発性高血圧, 高血圧-妊娠誘発性, 高血圧症合併妊娠, 妊娠性高血圧, 高血圧症-妊娠, 妊娠高血圧症, ﾆﾝｼﾝｺｳｹﾂｱﾂ, ﾆﾝｼﾝｺｳｹﾂｱﾂｼｮｳｺｳｸﾞﾝ, 妊娠高血圧症候群, 高血圧-妊娠性
Dutch zwangerschapsgeinduceerde verhoogde bloeddruk, zwangerschapshypertensie, zwangerschap; hypertensie, Hypertensie, zwangerschaps-, Zwangerschapshypertensie
Portuguese Hipertensão gestacional, Hipertensão induzida pela gravidez, Hipertensão arterial induzida pela gravidez, Hipertensão Gestacional, Hipertensão Induzida por Gravidez, Hipertensão Induzida pela Gravidez
Italian Ipertensione gestazionale, Ipertensione gravidica (PIH), Ipertensione da gravidanza, Ipertensione gravidica
German Bluthochdruck in der Schwangerschaft, schwangerschaftsbedingte Hypertonie, PIH schwangerschaftsbedingte Hypertonie, Gestationshypertonie, Hypertonie, schwangerschaftsinduzierte, Schwangerschaftsinduzierte Hypertonie
French Gestational hypertension, Hypertension gestationnelle (HG), Hypertension artérielle gravidique, Hypertension gestationnelle, Hypertension liée à la grossesse, Hypertension induite par la grossesse, Hypertension de la grossesse
Polish Nadciśnienie wywołane ciążą, Nadciśnienie ciążowe
Croatian HIPERTENZIJA UZROKOVANA TRUDNOĆOM, GESTACIJSKA HIPERTENZIJA
Hungarian Terhesség által kiváltott hypertonia, Gestationalis hypertonia, PIH terhesség által kiváltott hypertonia
Norwegian Svangerskapshypertoni, Graviditetsblodtrykk, Graviditetshypertoni
Derived from the NIH UMLS (Unified Medical Language System)

Ontology: Edema, proteinuria and hypertensive disorders in pregnancy, childbirth and the puerperium (O10-O16) (C0477811)

Concepts Disease or Syndrome (T047)
ICD10 O10-O16.9 , O10-O16
SnomedCT 200494008
English Edema, proteinuria and hypertensive disorders in pregnancy, childbirth and the puerperium, Edema,proteinuria+hypertens in pregnancy,childbrth,puerp, Edema,protur+HT preg+puerp, Oedema, proteinuria and hypertensive disorders in pregnancy, childbirth and the puerperium, Oedema,proteinuria+hypertens in pregnancy,childbrth,puerp, Oedema,protur+HT preg+puerp, [X]Edema, proteinuria and hypertensive disorders in pregnancy, childbirth and the puerperium, [X]Edema,proteinuria+hypertens in pregnancy,childbrth,puerp, [X]Edema,protur+HT preg+puerp, [X]Oedema, proteinuria and hypertensive disorders in pregnancy, childbirth and the puerperium, [X]Oedema,proteinuria+hypertens in pregnancy,childbrth,puerp, [X]Oedema,protur+HT preg+puerp, Edema, proteinuria and hypertensive disorders in pregnancy, childbirth and the puerperium (O10-O16), [X]Edema, proteinuria and hypertensive disorders in pregnancy, childbirth and the puerperium (disorder)
Spanish (X)edema, proteinuria y trastornos hipertensivos en el embarazo, el parto y el puerperio, (X)edema, proteinuria y trastornos hipertensivos en el embarazo, el parto y el puerperio (trastorno)
Derived from the NIH UMLS (Unified Medical Language System)

Ontology: Unspecified maternal hypertension (C0495183)

Concepts Pathologic Function (T046)
ICD10 O16 , O16.9
English Unspecified maternal hypertension, Unspecified maternal hypertension, unspecified trimester
German Nicht naeher bezeichnete Hypertonie der Mutter
Korean 상세불명의 모성 고혈압
Dutch Niet gespecificeerde hypertensie van moeder
Derived from the NIH UMLS (Unified Medical Language System)

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