Question

A 17-year-old G1P0 woman at 37 weeks gestation presents for a routine visit. She has no complaints, but is found to have an initial blood pressure of 138/89, and 144/91 on a repeat reading. This reading is noted to be a change from her previous visits, as her blood pressures have been in the 90-100/50-60 range since initiating care at eight weeks gestation. Her urinalysis is negative for protein and her comprehensive metabolic panel and the complete blood count are normal. Which of the following is the most likely diagnosis in this patient?

1) Chronic hypertension
2) Gestational hypertension
3) Mild preeclampsia
4) Severe preeclampsia
5) Normotensive

Answer 1

The 17-year-old pregnant woman with newly elevated blood pressure readings and no other abnormal findings is most likely experiencing gestational hypertension.

Step-by-step explanation:

The most likely diagnosis for a 17-year-old G1P0 woman at 37 weeks gestation with a blood pressure of 138/89 mm Hg initially, and 144/91 on a repeat reading, with no previous history of high blood pressure is gestational hypertension. This diagnosis is made noting an elevated blood pressure after 20 weeks of gestation in a previously normotensive patient, absent significant proteinuria and with normal laboratory findings. Chronic hypertension would have been present before 20 weeks or persistent after delivery, while mild or severe pre-eclampsia would typically include proteinuria and possibly additional systemic findings. As her current blood pressure is elevated compared to her previous readings but her urinalysis and metabolic panel are normal, gestational hypertension is the most accurate diagnosis.