Case Report: Managing Gestational Hypertension in a 32-Week Multigravida Pregnancy

Abstract

Hypertension in pregnancy is defined as blood pressure ≥140/90 mmHg occurring after 20 weeks of gestation without a prior history of hypertension. This condition is a major contributor to maternal and fetal morbidity and mortality worldwide and may progress to preeclampsia and other serious complications if not properly managed. This case report describes a 39-year-old woman (G3P2A0) at 32 weeks of gestation diagnosed with gestational hypertension. The patient was referred from a primary health center with a history of elevated blood pressure during antenatal care visits and recurrent headaches since 20 weeks of gestation. Physical examination revealed blood pressure of 157/91 mmHg without signs of severe preeclampsia, although proteinuria +1 was detected and required further evaluation. Identified risk factors included maternal age over 35 years, a history of hypertension in a previous pregnancy, and a family history of hypertension. Supporting examinations showed fetal growth appropriate for gestational age without evidence of complications. Management consisted of oral nifedipine 10 mg and regular blood pressure monitoring. The patient also received education regarding warning signs and the importance of routine follow-up. An expectant management approach was chosen due to the absence of maternal and fetal complications. This case highlights the importance of early detection, close monitoring, and appropriate management to prevent complications and improve pregnancy outcomes.