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FIGURE 40-1 Schematic shows normal reference ranges for blood pressure changes across
pregnancy. Patient A (blue) has blood pressures near the 20th percentile throughout pregnancy.
Patient B (red) has a similar pattern with pressures at about the 25th percentile until about 36
weeks when blood pressure begins to increase. By term, it is substantively higher and in the 75th
percentile, but she is still considered Normotensive.
Gestational Hypertension
Women whose blood pressures reach 140/90 mm Hg for the first time after
midpregnancy, but in whom proteinuria is not identified
Almost half of these women subsequently develop Preeclampsia Syndrome
Abnormally narrow spiral arteriolar lumen likely impairs placental blood flow. Nutritional Factors
Decreased soluble antiangiogenic growth factors may be involved in faulty
endovascular remodeling.