Chart — Maternal-Newborn
Hypertensive Disorders of Pregnancy Chart
The spectrum runs on two axes — when the hypertension started, and how much of the body is involved. Timing separates chronic from gestational; organ involvement separates gestational from preeclampsia; severity and seizures define the rest.
Educational use only. Criteria follow common ACOG-style conventions — classification and management belong to the provider team. This material supports nursing education and exam review. It is not medical advice and is not a substitute for clinical judgment, institutional policy, or medical direction. Always follow facility protocols and current provider orders.
The Spectrum Side by Side
| Disorder | Onset | Defining Criteria | Key Risks | Management Focus |
|---|---|---|---|---|
| Chronic hypertension | Before pregnancy or <20 weeks | ≥140/90 predating pregnancy or persisting >12 weeks postpartum | Superimposed preeclampsia, growth restriction, abruption | Pregnancy-safe antihypertensives; watch for superimposed disease |
| Gestational hypertension | ≥20 weeks | New ≥140/90 ×2, without proteinuria or organ involvement | Progression — a substantial share develop preeclampsia | Closer surveillance; treat severe-range pressures; reassess constantly |
| Preeclampsia | ≥20 weeks (or postpartum) | New hypertension + proteinuria, or + organ involvement without proteinuria | Progression to severe features; placental insufficiency | Surveillance, BP control, delivery timing — delivery is the cure |
| Preeclampsia with severe features | ≥20 weeks (or postpartum) | Any severe feature: ≥160/110, platelets <100k, LFTs ×2 with RUQ pain, Cr >1.1, pulmonary edema, headache/visual changes | Eclampsia, stroke, HELLP, abruption | Magnesium prophylaxis, urgent antihypertensives, expedited delivery planning |
| Eclampsia | Pregnancy through postpartum | Preeclampsia + new tonic-clonic seizures | Maternal hypoxia/injury, abruption, fetal compromise | Seizure safety, magnesium, stabilize mother first, deliver |
| HELLP syndrome | Third trimester or postpartum; BP may be modest | Hemolysis + elevated liver enzymes + low platelets | Hepatic hematoma/rupture, DIC, abruption | Severe-spectrum management — magnesium, stabilization, delivery |
Sorting Logic
• Before 20 weeks → chronic. After 20 weeks, new → gestational.
• Add proteinuria or organ involvement → preeclampsia.
• Add any severe feature → severe features (magnesium territory).
• Add seizures → eclampsia. Hemolysis + liver enzymes + low platelets → HELLP, at any blood pressure.
• Chronic + new proteinuria/worsening → superimposed preeclampsia — the hardest call, often the sickest patients.
Related Resources
Standards & sources
Fact-checked Jun 20, 2026This page is written to align with American College of Obstetricians and Gynecologists (ACOG) · AWHONN · American Academy of Pediatrics (AAP) — newborn. It is an educational summary, not a citation of any single document — always verify specific doses, values, and protocols against current guidelines and your facility policy. How we source content →