New-onset hypertension in the pregnant patient

The new onset of hypertension in pregnancy most often reflects preeclampsia, underlying chronic hypertension, chronic hypertension with superimposed preeclampsia, or gestational hypertension, and less commonly is due to substance abuse or any of several rare conditions. The term "pregnancy-induced hypertension" applies to all of these categories, but because it does not adequately and specifically define the patient's condition, its use therefore is discouraged. Attention to accurate identification of the specific type of "pregnancy-induced hypertension" is important since treatment varies depending on the diagnosis and the stage of pregnancy from observation with gestational hypertension to active intervention in the patient with chronic hypertension and superimposed preeclampsia. Both perinatal and maternal outcomes are dependent also on the categorization of the hypertensive disorders of pregnancy. Efforts to selectively identify, correctly diagnose, and optimally treat each hypertensive mother should help to achieve the best possible outcome with the least maternal risk.