A 29-week pregnant woman has a DBP of 100-109 mmHg and SBP of 150-159 mmHg. To which of the following categories of hypertension in pregnancy does the woman belong?

1. A

   Mild

2. B

   Moderate

3. C

   Severe

4. D

   Chronic

Appeared in: MP CHO - 2022

Explanation

• The patient's blood pressure, with a Systolic Blood Pressure (SBP) of 150-159 mmHg and a Diastolic Blood Pressure (DBP) of 100-109 mmHg, directly corresponds to the established clinical definition of moderate hypertension in pregnancy.
• This classification signifies a level of hypertension that requires increased surveillance and potential therapeutic intervention to prevent progression to a severe state and mitigate risks to both mother and fetus.
• It is distinguished from mild hypertension by the higher pressure readings and from severe hypertension by being below the critical threshold of 160/110 mmHg.

Why Other Options Were Wrong

• Option A: The patient's blood pressure readings (SBP 150-159, DBP 100-109 mmHg) are higher than the range for mild hypertension.
• Option C: The patient's blood pressure has not reached the threshold for severe hypertension.
• Option D: This term describes the timing of hypertension onset (before 20 weeks gestation), not its severity. The question asks to classify the current blood pressure reading.

Related Visual

Clinical Relevance

• Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Classification of hypertensive disorders in pregnancy as background academic context rather than a clinical decision trigger.
• Accurately classifying the severity of hypertension is a critical nursing responsibility as it dictates the plan of care, including frequency of monitoring, need for antihypertensive medications, and timing of delivery.
• A patient with moderate hypertension requires close observation for signs of progression to severe preeclampsia, such as severe headaches, visual disturbances, epigastric pain, and the development of proteinuria. Fetal well-being must also be monitored closely.
• What if? If the patient's SBP was 165 mmHg, she would be classified with severe hypertension. This would trigger immediate and aggressive management, including hospitalization and administration of fast-acting antihypertensive agents like labetalol or hydralazine to prevent maternal stroke, and magnesium sulfate for seizure prophylaxis.

How to Approach the Question

• First, identify the key clinical data provided in the question: the patient is 29 weeks pregnant, and her blood pressure is SBP 150-159 mmHg and DBP 100-109 mmHg.
• Next, recall the standard clinical classification system for the severity of hypertension in pregnancy.
• Compare the patient's blood pressure values against the established thresholds for mild, moderate, and severe hypertension.
• Note that 'Chronic' hypertension is a diagnosis based on the timing of onset (before 20 weeks), not the severity of a single reading at 29 weeks. Therefore, it can be eliminated as an incorrect answer for this specific question about classification.
• Match the patient's readings to the correct category. The values 150-159/100-109 mmHg fit the definition of 'Moderate' hypertension.

Concept Tested & Keywords

• Concept Tested: Classification of hypertensive disorders in pregnancy
• Stem keywords: 29-week pregnant, DBP 100-109 mmHg, SBP 150-159 mmHg, hypertension in pregnancy
• Lead-in keywords: categories
• Clinical cues: Blood pressure reading of 150-159/100-109 mmHg is a key indicator for moderate hypertension.

Question ID

Q-YZ5dsYE7qo637g_YGBxG

Copy ID

Reference Book

E6 Obstetrics Williams p. 68-91