💥Timing of Delivery in Gestational Hypertension How Decisions Are Made

In gestational hypertension,

the question is rarely if delivery will happen 

but when.

Timing of delivery is a balance between:

 • Maternal safety

• Fetal maturity

• Disease stability over time

There is no single gestational age that fits all cases.

🔹 When expectant management is appropriate

Delivery is usually deferred when: 

• Blood pressure remains in the mild to moderate range

• There are no symptoms of preeclampsia

• Laboratory results are normal

• Fetal growth and wellbeing are reassuring.

In these cases, continued pregnancy under close surveillance is safe and appropriate.

🔹 When delivery should be considered earlier

Delivery is indicated or strongly considered when: 

• Blood pressure becomes severe or difficult to control

• Features of preeclampsia develop

• Maternal symptoms appear

• Laboratory abnormalities emerge

• Fetal growth restriction or compromise is detected.

At this point, prolonging pregnancy may increase risk

without meaningful fetal benefit.

🔹 Gestational age matters

Management at:

 • 28 weeks

is very different from

• 37 weeks

As pregnancy advances,

the threshold for intervention becomes lower,

and the balance increasingly favors delivery.

🎯 Key principle:

In gestational hypertension,

delivery is not a failure of care 

it is often the definitive treatment.

Good timing is not based on blood pressure alone,

but on trend, context, and maternal–fetal assessment.

Dr Rabab Cares

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