Answer: Preeclampsia is defined by hypertension and proteinuria. For women who do not have chronic hypertension, an elevation above 140 mmHg systolic or 90 mmHg diastolic meets the criteria. Proteinuria is defined by more than 300 mg of protein in a 24-hour urine collection. In the past, an increase in blood pressure above baseline (a [...]

Answer: Hypertension that predates pregnancy or is identified before 20 weeks’ gestation is classified as chronic hypertension. If a woman begins her prenatal care after 20 weeks, and if she has hypertension that persists more than 12 weeks postpartum, she is also considered to have chronic hypertension. Reference: American College of Obstetricians and Gynecologists: Chronic [...]

Answer: In 2000, the National High Blood Pressure Education Program Working Group revised the classification system for this set of conditions. Four categories are now recognized for hypertension in pregnancy: chronic hypertension, gestational hypertension, preeclampsia, and chronic hypertension with superimposed preeclampsia. The American College of Obstetricians and Gynecologists has adopted the Working Group’s system. Reference: [...]

Answer: In a pregnant woman, a systolic blood pressure above 140 mmHg or a diastolic blood pressure above 90 mmHg is considered hypertension. Reference: American College of Obstetricians and Gynecologists: Diagnosis and Management of Preeclampsia and Eclampsia. ACOG Practice Bulletin No. 33. Obstet Gynecol 99:159-167, 2002

Answer: The mainstay of treatment is symptomatic therapy with close attention to fluid balance. Frequent small meals and avoidance of aggravating food sources are important. Ginger tea is a much touted anecdotal remedy, and powdered ginger has been proven effective when studied clinically. A randomized clinical trial of vitamin B6 versus placebo proved its efficacy [...]

Answer: The causes of NVP/HG remain poorly understood. The major theories of causation involve hormonal variables, abnormal gastric motility, and psychosocial stress. Hormonal variables: Some women with hyperemesis appear to be hyperthyroid, which is associated with higher levels of circulating human chorionic gonadotropin (hCG) or higher biological activity of hCG. There has also been some [...]

Answer: The most commonly reported serious complication associated with hyperemesis is Wernicke’s encephalopathy due to thiamine deficiency, sometimes associated with central pontine myelinolysis. A classic triad of ataxia, confusion, and oculomotor signs characterizes this syndrome. Women with prolonged vomiting should receive supplemental thiamine to prevent this dangerous complication. Other complications related to prolonged vomiting include [...]