Which condition can be excluded in a pregnant patient with elevated blood pressure but no proteinuria?

In the context of a pregnant patient with elevated blood pressure but no proteinuria, the exclusion of preeclampsia as a diagnosis is based on the defining characteristics of the condition. Preeclampsia is characterized not only by hypertension but also, crucially, by the presence of proteinuria or signs of end-organ dysfunction. When proteinuria is absent, the diagnosis of preeclampsia cannot be made, as it does not meet the necessary criteria.

Gestational hypertension can occur in the absence of proteinuria, making it a potential diagnosis in this scenario. Chronic hypertension refers to high blood pressure that existed before pregnancy or that is diagnosed before the 20th week of gestation, and it does not hinge on the presence of proteinuria. Therefore, the presence of elevated blood pressure without proteinuria effectively rules out preeclampsia as a possible diagnosis. This understanding is key in managing the health of both the mother and the fetus during pregnancy.