[Gestational hypertensions: definitions and consequences in outcome of pregnancy].

Hypertensive pathologies during pregnancy lack definition. Meanwhile, we can offer the following definitions: - Gestational hypertension (GHT): Systolic HT >or= 140 mmHg and/or diastolic blood pressure 90 mmHg. Which occur beyond the 20th week of amenorrhea and fading before the 42nd day postpartum. - Preeclampsia: Systemic HT associated with a proteinuria (> 0,3 g/24 h) also arising beyond the 20th week of amenorrhea and resolving by the 6th week postpartum. However, in the setting of a GHT associated with a number of abnormal signs & symptoms (i.e. hyper-reflexia, epigastric pain, etc.) and/or abnormal biological values (i.e. raised transaminase levels, thrombocytopenia, hyperuricaemia, haemolysis) and/or IUGR, PE must be considered until proven otherwise. - HELLP syndrome: Association of haemolysis, elevated liver enzymes (transaminases & LDH) and thrombocytopenia. However, HELLP syndrome can exist without haemolysis. - Eclampsia is defined as the occurrence of tonic-clonic seizures in a setting of GHT. Assessing the morbidity and mortality of both the mother and the foetus, in the setting of GHT, is a challenge because of the absence of registry, and because of the high amount of bias (gestational age, birth weight, presence or absence of risk factors in the studied population, belonging to a developed or a developing nation, etc.) which all account for the large discrepancies in the results to such an extent that the relative risk to the mother can vary from simple to the double, and the foetal risks are highly variable from one study to the next. Copyright (c) 2010 Elsevier Masson SAS. All rights reserved.