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Gestational hypertension — DRCOG MCQ

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ModerateAntenatal CareGestational hypertensionDRCOG

A 40-year-old woman at 28 weeks has blood pressure 146/94 mmHg and no proteinuria. Repeat measurement 20 minutes later is 148/92 mmHg. She has no headache or visual symptoms and fetal growth has been normal. What is the most likely diagnosis?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: A — Gestational hypertension

New hypertension after 20 weeks without proteinuria or systemic features is gestational hypertension. Chronic hypertension would be present before pregnancy or before 20 weeks. Severe pre-eclampsia requires additional clinical or laboratory features, and HELLP syndrome involves haemolysis, elevated liver enzymes and low platelets. The pearl is that gestational hypertension can progress, so it still requires structured surveillance.

Reference: NICE NG133