A sustained rise of blood pressure to 140/90 mm Hg or more on at least two occasions 4 or more hours apart beyond the 20th week of pregnancy or within the first 48 hours of delivery in a previously normotensive woman is called gestational hypertension. It is associated with a much higher incidence of essential hypertension in later life than preeclampsia. Both, thus appear to be two phases of the same disorder. It should fulfill the following criteria

1) Absence of any evidences for the underlying cause of hypertension

2) Generally unassociated with other evidences of preeclampsia (edema or proteinuria).

3) Majority of cases are more than or equal to 37 weeks' pregnancy.

4) Generally not associated with hemoconcentration or thrombocytopenia, raised serum uric acid level or hepatic dysfunction.

5) The blood pressure should come down to normal within 12 weeks following delivery. However, gestational HTN may go to proteinuric phase and may evolve to preeclampsia. It is a retrospective diagnosis. The hypertensive effect may be a stress response. There are no longer any real differences in management between PE and gestational HTN, in terms of BP management and in the decision to deliver.

A case of severe HTN, with appearance of symptoms or abnormal laboratory values, suggests delivery.

Gestational edema is excessive accumulation of fluid with demonstrable pitting edema over the ankles greater than 1 after 12 hours in bed or gain in weight of 2 kg or more in a week due to influence of pregnancy.

Gestational proteinuria is the presence of protein of more than 0.3 g in the 24 hours' urine during or under the influence of pregnancy in the absence of hypertension, edema or renal infection. It may be orthostatic proteinuria.

HOMOEOPATHIC MEDICINES FOR MANAGING GESTATIONAL HYPERTENSION: -

1) Aconite:- it is a useful Homoeopathic remedy particularly for patients who suffer from high blood pressure which occurs suddenly, and when patient is constantly faced by a fear of dying.

2) Nux vomica:- it is effective in lowering down high blood pressure arising due to overeating.

3) Lycopodium:- it is a general, effective Homoeopathic remedy for patients suffering from high blood pressure.

4) Ignatia:- High blood pressure arising due to emotional upsets, anger, grief etc can be treated effectively.

5) Lachesis:- Lachesis is a homoeopathic remedy which is particularly effective in treating high blood pressure occuring during Menopause.