Hypertension in Pregnancy, Dr. Jessica Peterson | Evening Rounds: Ambulatory Lecture Series

Dr. Jessica Peterson, an assistant professor of maternal-fetal medicine at the University of Chicago, presents a comprehensive lecture on hypertension in pregnancy. She defines chronic hypertension as elevated blood pressure before 20 weeks or persisting 12 weeks postpartum, with thresholds of 140/90 mmHg. She emphasizes the increased risks of fetal growth restriction, preterm birth, preeclampsia, and abruption, and discusses management strategies including blood pressure medication, aspirin prophylaxis starting at 12 weeks, serial fetal growth assessments, and antenatal testing. She then covers gestational hypertension, which occurs after 20 weeks in previously normotensive women, and highlights the need for close monitoring due to risks of preeclampsia and severe hypertension. The lecture distinguishes gestational hypertension from preeclampsia without severe features, primarily by the presence of proteinuria. Preeclampsia with severe features is characterized by severe hypertension (≥160/110) or end-organ dysfunction, such as thrombocytopenia, renal insufficiency, or elevated liver enzymes, and requires inpatient management. Dr. Peterson stresses the importance of recognizing warning signs like persistent headache, visual disturbances, and right upper quadrant pain, and encourages clinic staff to proactively ask about symptoms and perform urine dipstick tests. She concludes by noting the long-term cardiovascular risks associated with hypertensive disorders of pregnancy and answers questions from the audience.