A 27-year-old woman at 20 weeks of gestation is found to have BP 150/98 mmHg on two occasions. She has no proteinuria, no symptoms, and normal laboratory values. What is the correct classification of her hypertension?

• A Chronic hypertension ✓
• B Gestational hypertension
• C Transient hypertension of pregnancy
• D White coat hypertension

Explanation

Hypertension documented before 20 weeks of gestation, or persisting beyond 12 weeks postpartum, is classified as chronic hypertension. Gestational hypertension is defined as new hypertension after 20 weeks without proteinuria or severe features, so option B fails on the timing criterion alone. Transient hypertension is a retrospective postpartum diagnosis, and white coat hypertension requires normal out-of-office readings, which are not described here.

Reference: Williams Obstetrics, 26th ed.

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