What condition should be suspected in a pregnant woman presenting with hypertension and swollen ankles?

The presentation of hypertension and swollen ankles in a pregnant woman raises strong suspicion for preeclampsia. Preeclampsia is characterized by new-onset high blood pressure and often accompanied by edema, particularly in the lower extremities, due to fluid retention.

In the context of pregnancy, preeclampsia typically occurs after the 20th week of gestation and can lead to more serious complications if left unmonitored. The presence of hypertension and swelling is particularly significant, especially if the swelling is sudden or accompanied by other symptoms such as protein in the urine or headache.

While gestational diabetes is a concern during pregnancy, it primarily affects glucose metabolism rather than causing hypertension or edema directly. A hypertensive emergency is a severe form of high blood pressure that can occur in many contexts, but it does not specifically relate to the typical presentation in a pregnant woman. Lastly, a condition unrelated to pregnancy would not correlate with the specific symptoms of hypertension and swelling noted during this critical time.

These characteristics make preeclampsia the most probable diagnosis in this scenario, highlighting the need for careful monitoring and management for both the mother's and baby's health.