Which condition is defined by new onset of elevated blood pressure at 20 or more weeks without proteinuria?

• A. Gestational Diabetes
• B. Preeclampsia
• C. New Onset of Elevated BP at 20 or More Weeks Without Proteinuria
• D. Chronic Hypertension

Answer: (C)

New onset hypertension after 20 weeks of gestation without proteinuria is gestational hypertension. This diagnosis recognizes that the high blood pressure is tied to the pregnancy and is defined by the absence of protein in the urine, which distinguishes it from preeclampsia (hypertension with proteinuria or end-organ dysfunction) and from chronic hypertension (preexisting before pregnancy or before 20 weeks). The important idea is that after 20 weeks, if BP is elevated but there’s no proteinuria, it fits gestational hypertension and requires careful monitoring because it can progress to preeclampsia if proteinuria or other symptoms develop. Management focuses on continued BP and fetal monitoring and planning delivery based on maternal and fetal status.