A healthy 27-year-old G2P1 develops blood pressure of 148/96 mmHg on two readings 6 hours apart at her 35-week antenatal visit. Repeat testing shows no proteinuria, normal platelet count, normal liver enzymes, and normal creatinine. She remains asymptomatic. What is the correct diagnosis?

• A Gestational hypertension ✓
• B Chronic hypertension
• C Pre-eclampsia
• D White coat hypertension

Explanation

Gestational hypertension is new onset hypertension (BP 140/90 mmHg or more) after 20 weeks of gestation in the absence of proteinuria and without any severe feature. Chronic hypertension is defined by hypertension detected before 20 weeks, so option B fails on timing. Pre-eclampsia requires proteinuria or an affected organ system, both absent here. White coat hypertension refers to raised clinic readings with normal ambulatory or home readings, which cannot be assumed from two separate abnormal readings.

Reference: Williams Obstetrics, 26th ed.

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Written and medically reviewed by the StethoPrep medical team.