Gestational hypertension

Case history

A 30-year-old woman (gravida 2 para 1) at 22 weeks' gestation presents to the outpatient obstetrics clinic for a routine antenatal visit. She has no significant past medical history. Her first pregnancy was uncomplicated and her child (now 4 years of age) is doing well. On examination, she is afebrile with a respiratory rate of 16 breaths per minute, pulse of 91 bpm, and blood pressure (BP) of 132/102 mmHg. Her previous BP reading was 120/80 mmHg. Urinalysis is negative for glucose and protein. The woman is asked to return in 1 week for a BP check. On check-in at the clinic, the woman tells the nurse that she does not have any symptoms. However, on examination, her BP has risen to 142/106 mmHg. Urinalysis remains negative for glucose and protein.