What should be suspected if a pregnant patient has repeated high blood pressure readings while in a stressful situation but normal readings in a relaxed environment?

The situation described, where a pregnant patient exhibits high blood pressure readings in stressful situations but normal readings in relaxed environments, points towards a phenomenon known as white coat syndrome. This condition typically refers to elevated blood pressure that occurs in medical settings due to anxiety or stress, often triggered by the presence of healthcare providers or the surroundings of a clinic or hospital.

In the context of hypertension management, it is crucial to differentiate between genuine hypertension and white coat syndrome. While the other conditions listed—such as preeclampsia, gestational hypertension, and chronic hypertension—are characterized by consistently high blood pressure readings regardless of the environment, white coat syndrome specifically describes transient elevations that are not necessarily indicative of ongoing hypertension. Therefore, if a patient has normal readings when relaxed, it suggests that the high readings in stressful situations may not reflect their true baseline blood pressure levels. Recognizing this pattern allows healthcare providers to adopt appropriate monitoring strategies and avoid unnecessary interventions.