Chronic Hypertension in Pregnancy

Chronic hypertension is blood pressure at or above 140/90 mm Hg that predates pregnancy or is identified before 20+0 weeks. Hypertension first recognized during pregnancy that remains elevated beyond the early postpartum period is also reclassified as chronic. The clinical problem has two connected parts: controlling maternal blood pressure and recognizing placenta-mediated disease. Chronic endothelial and small-vessel injury can impair trophoblast invasion and spiral artery remodelling during early placentation. That is why chronic hypertension raises the risk of fetal growth restriction, placental abruption, and preterm birth even when superimposed preeclampsia never develops. A capable nurse keeps two timelines in view. The first is routine blood-pressure control throughout pregnancy. The second is the sudden change in priority created by severe hypertension, new end-organ dysfunction, or symptoms suggesting preeclampsia, pulmonary oedema, seizure, or placental abruption.