Pre-eclampsia is a serious pregnancy-specific hypertensive disorder diagnosed after 20 weeks of gestation with new-onset hypertension (≥140/90 mmHg) and proteinuria or end-organ dysfunction. Monitor blood pressure at home using a validated device and follow a DASH diet to help manage BP. Seek immediate medical attention for BP ≥160/110 mmHg or consistent readings ≥140/90 mmHg.
January 14, 2025

Pre-Eclampsia and Gestational Hypertension Monitoring Tips

Evidence-Based Over-The-Counter Guide

William Shen

William Shen

Co-founder & CPO

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Pre-eclampsia is a pregnancy-specific hypertensive disorder characterized by new-onset hypertension and end-organ dysfunction after 20 weeks of gestation. It poses risks to both maternal and fetal health. The exact pathophysiology remains unclear, but it is believed to involve abnormal placental development and endothelial dysfunction.

Diagnosis Criteria:

  • Systolic BP ≥140 mmHg or diastolic BP ≥90 mmHg on two occasions, at least 4 hours apart, in a previously normotensive woman.

  • Proteinuria ≥300 mg/24 hours, protein/creatinine ratio ≥0.3, or dipstick 1+.

  • In the absence of proteinuria, end-organ dysfunction such as thrombocytopenia, renal insufficiency, liver dysfunction, pulmonary edema, or neurological symptoms can confirm the diagnosis.

First-line recommendations:

  • Monitor blood pressure: A home blood pressure monitor is the gold standard in tracking BP trends, outperforming sporadic in-office measurements if a validated device is used. OMRON Bronze Upper Arm Blood Pressure Monitor (FDA Reg. 1450057).

  • DASH Diet (Dietary Approaches to Stop Hypertension): A heart-healthy diet emphasizing fruits, vegetables, whole grains, lean proteins, and low-fat dairy while reducing sodium intake (<2300 mg/day) and limiting saturated fats and added sugars. The DASH diet is proven to lower blood pressure significantly by 10-20 mm Hg. Recommended DASH diet guide.

  • When to seek immediate medical attention: If blood pressure is ≥ 160 mm Hg systolic or ≥ 110 mm Hg diastolic or consistently ≥140/90 mmHg as complications of pre-eclampsia can be dangerous for both the fetus and the mother.

Professional management:

  • Delivery: The only definitive cure. Timing depends on gestational age and disease severity. 

  • Antihypertensive therapy: Doctors use agents safe during pregnancy, such as labetalol, nifedipine, or methyldopa

  • Magnesium sulfate: For seizure prophylaxis in severe pre-eclampsia. Loading dose 4-6 g IV over 20-30 minutes, followed by 1-2 g/hour IV infusion.

Citations:

Gestational Hypertension and Preeclampsia: ACOG Practice Bulletin, Number 222. Obstet Gynecol. 2020 Jun;135(6):e237-e260. doi: 10.1097/AOG.0000000000003891. PMID: 32443079.

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