A pregnant patient with hypertension is at an increased risk for which condition during pregnancy?

• A. Gestational diabetes
• B. Pre-eclampsia
• C. Placenta previa
• D. Hyperemesis gravidarum

Answer: (B)

During pregnancy, a patient with hypertension is particularly at an elevated risk for developing pre-eclampsia. Pre-eclampsia is characterized by new-onset hypertension and proteinuria after the 20th week of gestation. It is a significant concern because it can lead to severe complications for both the mother and the fetus, including organ failure, placental abruption, and intrauterine growth restriction.

The risk factors for pre-eclampsia include not only pre-existing hypertension but also factors like obesity, a history of pre-eclampsia in previous pregnancies, and certain chronic conditions. The pathophysiology involves abnormal placentation and inadequate remodeling of the maternal spiral arteries, leading to placental insufficiency and maternal endothelial dysfunction.

Gestational diabetes, placenta previa, and hyperemesis gravidarum, while important conditions, do not have the same direct correlation with pre-existing hypertension as pre-eclampsia. Thus, the strong association of hypertension with pre-eclampsia makes it the most relevant condition to consider in this scenario.