The American College of Obstetricians and Gynaecologists (ACOG) task force  categorises HDsP as chronic hypertension, gestational hypertension, preeclampsia-eclampsia and superimposed preeclampsia
. The International Society for the Study of Hypertension in Pregnancy (ISSHP)  additionally includes white coat hypertension as it increases the risk for preeclampsia.
However, there is still much confusion regarding the diagnosis of certain categories of hypertensive disorders--particularly preeclampsia with severe features and superimposed preeclampsia
with or without severe features.
* chronic hypertension with superimposed preeclampsia
: hypertension complicated by development of multisystem involvement during the course of the pregnancy--often a challenging diagnosis, associated with greater perinatal morbidity than either chronic hypertension or preeclampsia alone.
Upon hospital presentation, she was diagnosed with chronic hypertension with superimposed preeclampsia
based on a 24-hour urine protein of 388 mg.
Patients with history of chronic HTN without proteinuria, patients with previous history of renal disease and patients with chronic HTN with superimposed preeclampsia
(new onset proteinurea) were excluded.
is a condition characterized by increasing blood pressure and proteinuria after the 20th week of pregnancy in women with pre-existing chronic hypertension (2).
The 141 cases of preeclampsia and chronic hypertension with superimposed preeclampsia
with singleton births diagnosed in our institution from January 2010 to December 2013 were retrospectively reviewed.
The application of BPSM was influenced mainly by superimposed preeclampsia
versus preeclampsia de novo.
Previous pre-eclampsia as an independent risk for superimposed preeclampsia
was reported to be associated with about 5-fold increase for the risk (OR: 4.757; 95% CI: 1.261-17.938).
Study participants were [greater than or equal to]20 weeks gestational age and had new onset of hypertension with or without suspicion of preeclampsia or chronic hypertension (before 20 weeks of gestation) with suspected superimposed preeclampsia
. Hypertension was defined as systolic blood pressure [greater than or equal to]140 mmHg and/or diastolic blood pressure [greater than or equal to]90 mmHg, measured twice at least 6 h apart.
Approximately 20% of women with chronic hypertension and 50% of those with chronic severe hypertension develop superimposed preeclampsia
Serum and placental lipid peroxides in chronic hypertension during pregnancy with and without superimposed preeclampsia
. Hypertens Pregnancy 18: 139-146.