Gestational hypertension is defined as new-onset hypertension after 20 weeks of gestation without proteinuria.

• A. After 20 weeks with proteinuria
• B. After 20 weeks without proteinuria
• C. Before 20 weeks with proteinuria
• D. Only postpartum

Answer: (B)

Gestational hypertension refers to new high blood pressure that appears after 20 weeks of pregnancy and, importantly, occurs without protein in the urine. The absence of proteinuria is what separates it from preeclampsia, which is hypertension after 20 weeks plus proteinuria or other organ dysfunction. If hypertension started before 20 weeks, it would be considered chronic hypertension rather than gestational. Postpartum hypertension isn’t gestational hypertension because the condition is defined during pregnancy. So the best description is high blood pressure after 20 weeks with no proteinuria.