CASE-1

CASE:

A 23-year-old woman has a normal blood pressure (118/82mmHg) when reviewed at 8 weeks of pregnancy. In pregnancy week-24, she is reviewed by her midwife and diagnosed to have a blood pressure of 148/96mmHg. Urinalysis is normal.

QUESTIONS:

1. What is the likely diagnosis? 

2. What are the complications the patient's high blood pressure places her at increased risk of? 

3. Should she receive drug treatment? If so, with which drug? If not, how should she be managed?

Try to answer these questions on your own in the comment section below.

Answers are provided below.

Reference: Clinical Pharmacy and Therapeutics-Textbook

Roger Walker 

Cate Whittlesea

ANSWERS:

1. She might have gestation-induced hypertension or chronic hypertension that had previously been masked by the fall in blood pressure that happens in early pregnancy.

2. Pre-eclampsia and intrauterine growth retardation.

3. Some specialists would not treat unless the blood pressure was >170/110 mmHg

or other complications were present. If she were treated, methyldopa would be a suitable choice. In any event, she needs close monitoring of her blood pressure, urinalysis, and fetal growth.

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