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Pregnancy induced hypertension

Updated on February 6, 2015

How do you care for your pregnancy if you have hypertension?

Pregnancy induced hypertension is hypertension that occurs during pregnancy that is, the rise in blood pressure during pregnancy. Pregnancy induced hypertension refers to a pregnancy complication that is manifests through high blood pressure, swelling caused by fluid retention, as well as protein in the urine. Pregnancy induced hypertension affects nearly one out of every fourteen pregnant women. It also occurs mostly during the first pregnancy or during late pregnancies for women older than forty years in age. Pregnancy induced hypertension develops mostly after the twentieth week but can also develop during delivery, or just after delivery. Despite the fact that, many mothers who suffer pregnancy induced high blood pressure bear healthy babies, and without without major complications, high blood pressure during pregnancy may put the both the mother and the baby at risk. Mother who have a history of high blood pressure are at a higher chance of developing complications during pregnancy than those with no blood pressure history. Pregnancy induced high blood pressure has effects ranging from mild to severe and depending on the severeness may be dangerous. The mother’s kidneys may be affected causing the baby to be born underweight or prematurely. This paper aims to discuss pregnancy induced pregnancy, its causes, treatment and management, and also the predisposing factors. Literature used in this essay includes books as well as class knowledge.

Risks associated with pregnancy induced hypertension

Manifestation of Pregnancy Induced Hypertension
Pregnancy induced hypertension manifests itself in three different ways; thus, the three classes of pregnancy induced hypertension.
First is the chronic hypertension. This occurs when the blood pressure reading is around 140/90, and the pregnancy is twenty weeks old or less.
Next, there is gestational hypertension. This develops after twenty weeks into pregnancy. This hypertension disappears after delivery.
Finally, there is preeclampsia, which is a severe case of chronic and gestational hypertension. It occurs after twenty weeks of pregnancy and may persist even after delivery. Preeclampsia may lead to serious complications to both the mother and the baby if not treated.
Diagnosis, Management and Treatment of Pregnancy Induced Hypertension
High blood pressure affects the normal blood supply to the body organs including the placenta. Consequently, pregnancy-induced hypertension, like blood pressure also inhibits the normal blood supply to the unborn baby through the placenta. This may lead to oversupply of blood to the unborn baby. If a woman is diagnosed with pregnancy induced hypertension, the care giver may order for an ultra sound test to check the conditions of the baby. The ultra sound helps the care giver know whether the baby is growing well, as well as whether a woman has a normal amount of amniotic fluid. The care giver may also order for a biophysical profile (BPP), which is meant to check on the wellbeing of the baby. In case the baby is growing poorly, the pregnant woman is taken through a Doppler ultrasound to check the flow of blood to the baby. The care giver may also request the pregnant woman to go through a series of other tests, as well as collect urine for twenty-four hours. The tests are targeted to ascertain the health condition of the mother and the baby. The urine test is meant for checking for the presence of proteins in urine, which may be an indicator of other health complications. This test has a higher accuracy as compared to the urine dip that is done during each prenatal visit. Pregnant women are also required to take blood pressure tests two times a week as well as blood tests weekly. The tests are used to tell whether a woman has preeclampsia or not. The tests also help the care giver to gauge any later changes in the condition of the woman. In addition, a pregnant woman undergoes periodic biophysical profiles and nonstress tests so as to check the health status of the baby. The care givers manage pregnancy induced hypertension depending on how high he blood pressure is, the condition of the baby, as well as how old the pregnancy is. However, the care giver may require the pregnant women to cut back on the activities they do, to reduce body energy requirements thereby lowering the rate of blood circulation, or may refer the woman to a perintologist. A perintologist specializes in high- risk pregnancies. They conduct a number of specialized tests and treatments to ensure that the pregnancy is safe. If the pregnancy has not is less than 37 weeks old, and the pregnant woman’s blood pressure is not highly elevated, the care giver may order that the pregnant woman be hospitalized to enable the care giver pay a close monitoring on the condition of the baby and the mother. After hospitalization, if the condition of the baby and the woman is fine, the woman may be sent home to take things slow and put on some degree of reduced activity. However, a pregnant woman should pay regular visits to the care giver so as to monitor their blood pressure, check their urine for protein, as well as monitor for any changes in the general condition of the woman. However, there may be a casual arrangement between the pregnant woman and the care giver to perform a blood pressure tests at home. The develepment of the baby is closely monitored with weekly or biweekly biophysical profiles and nonstress tests. After every three weeks, the pregnant woman should go through an ultrasound so as to keep a watch o the baby’s condition. Pregnant women can also monitor the development of their baby through daily fetal kick counts. This helps monitor the condition of the baby between prenatal visits. Fetal kicks are caused by distress or excitements, if they are so often or so few, this is an indicator that the foetus is in distress.
However, a woman should notify the care giver as soon as they notice lesser baby movements than before. Immediately the woman develops symptoms of pregnancy induced hypertension; they should consult the care givers so as to arrest the situation before it goes out of hand thus preventing complications. Such symptoms include; swelling, severe or persistent headaches, pains in the upper abdomen, changes in vision, sudden weight gain, vomiting as well as nausea. However, a woman may also have vaginal spotting or bleeding and uterine tenderness and pain. Sometimes, the blood pressure of the pregnant woman may be highly elevated to a reading of 160/110 or higher. In such cases, a woman is put under medication to lower their blood pressure, and hospitalized until delivery. If the pregnancy is thirty-four weeks old or less, a woman is put under corticosteroids so as to increase the rate of development of the baby’s lungs as well as other organs. However, if the baby doesn’t thrive in the womb or the pregnancy is thirty-seven weeks old or more, delivery is induced or the baby is delivered prematurely through c- section to prevent the baby affecting the health of the mother. This depends on the situation of the baby and the mother. The woman may be hospitalized till delivery if delivery is not done right away, so as to closely monitor the baby’s development. Treatment of pregnancy induced hypertension depends on how severe it is. Mild cases can be cured from home. However, this requires the woman to maintain an environment that is both restful and quiet, and maintain less activity. Women diagnosed with pregnancy induced hypertension should strictly follow the guidelines they get from their health care providers as well as maintain their scheduled appointments. Severe cases require admission into the hospital for close monitoring to prevent seizures. However, taking at least eight glasses of water daily would do a great deal in helping prevent hypertension.
Risk Factors
There are factors that increase the chances of developing pregnancy induced hypertension. Age of a woman is one of the predisposing factors. People who are under twenty years old or over forty years old are at a higher chance of getting hypertension. Presence of chronic hypertension in the family and previous cases of hypertension also increases the chances of getting pregnancy induced hypertension. Being under weight or over weight and having kidney diseases also increases the chances of having pregnancy induced hypertension. Those mothers who are expecting twins or triplets are at a higher risk compared to those expecting one baby. Use of alcohol or tobacco and too much salt also increases the chance of suffering from pregnancy induced hypertension. Early and late pregnancies thus pose a health risk for the mother. It is also advisable that mothers should adopt a healthy lifestyle during pregnancy to lower the chances of pregnancy hypertension.
After Delivery
Most women are very concerned with their physical as well as health condition after delivery. After birth, the blood pressure of women who suffered pregnancy induced hypertension is monitored closely by the care givers. However, a woman should notify their caregivers in case of any sign of hypertension, whether at home or in the hospital as this helps arrest the situation in time. Most women regain their normal blood pressure after pregnancy. Some women suffer from elevated blood pressure even three months after delivery. Such women are usually diagnosed with chronic hypertension. Hypertension, if not detected before pregnancy or during the first trimester, it may not be detected till the final trimester, or even after delivery, because blood pressure normally decreases during the first and second trimester.
Dangers of Pregnancy Induced Hypertension
Hypertension during pregnancy inhibits the normal blood and oxygen supply to the placenta, thus the baby receives less than sufficient nutrients and oxygen, making it be born underweight. There may be abruption of the placenta, seizures in the mother, kidney failure, blood clotting as well as liver problems. Early delivery may also result from pregnancy induced pregnancy. There is the need for training women about pregnancy induced hypertension, its causes, diagnosis, as well as dangers to prevent pregnancy complications. There are many mother who are not aware of pregnancy induced hypertension, and may take it lightly, leading to complications during later pregnancies.
An early identification of women who are at the risk of getting pregnancy induced hypertension would be of help to prevent complications. Women need be educated about the signs and symptoms of pregnancy- induced hypertension so that they can visit care givers immediately they get such symptoms. If recognized early, pregnancy- induced hypertension can be treated easily, but the treatment is much more complicated for advanced cases. In very severe cases, a pregnant woman with high blood pressure and proteinura may get tonic- clonic seizures. This is an extreme condition of pregnancy induced hypertension and is called eclampsia and poses a health risk for the mother and the baby and may lead to the induced miscarriage to save the life of the mother.

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