Pregnancy Induced Hypertension

By on September 1, 2012 with No Comments

There are different types of blood pressure, which affect pregnant women and it is essential that they are examined by a doctor and treatment given accordingly. The three main types of blood pressure during pregnancy are chronic hypertension in which the blood pressure increases before the 20th week of pregnancy or it is present even before a woman becomes pregnant. At times a woman may have high blood pressure and she only comes to realize it when she goes for her first prenatal clinical check up.

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The second type of hypertension, which is witnessed in pregnant women, is gestational hypertension. Some women develop high blood pressure as they get close to the end of their pregnancy. However, with this type of high blood pressure, the women do not have any other associated symptoms.

Third common type of high blood pressure in pregnant women is pregnancy-induced hypertension- PIH. This is also called toxemia or pre-eclampsia blood pressure. This is a serious condition, which can cause a lot of harm to both the pregnant women and the baby and therefore it should be treated well and in advance. The disorder develops after the 20th week of pregnancy and it causes other problems such as protein in urine and blood changes.

What are the causes of Pregnancy Induced Hypertension ?

There are various conditions which are associated with pregnancy-induced hypertension and these are such as kidney disease, already existing high blood pressure and diabetes. Other conditions are such as multiple fetuses and occurrence of pregnancy induced hypertension in a previous pregnancy. PIH affects about 5-8% of pregnant women. It is prevalent in pregnant women who are below 20 years and in those pregnant women above 40 years.

 Symptoms of pregnancy-induced hypertension

The common signs of PIH are a high blood pressure, which is more than 140/90 mmHg. 140 is the systolic pressure reading and the 90 is the diastolic pressure reading. Another common sign is swelling. A patient will also experience protein in urine and sudden gain in weight.

In other cases, there may be double or blurred vision. Nausea and vomiting may also be experienced. Pregnant women will also experience abdominal pain and urinating in small amounts. There is also a change in kidney and liver functions.

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Patholphysiology of PIH

Although pregnancy induced hypertension is a major maternal fatality cause and a main contributor in maternal and prenatal morbidity, the mechanism in which the condition manifests have not yet been conclusively analyzed. The pathogenesis of PIH has not been elucidated in-depth, however, studies carried out in the past decade have shade some light on the mechanism of pathogenesis of PIH.

One of the aspects that contribute to this hypertension is the reduced uteroplacental perfusion. This happens as a result of abnormal cytotrophoblast invasion of the spiral arterioles. Placental ischemia is a condition which is thought to contribute to dysfunction of the maternal vascular endothelium. This further leads to formation of endothelin and thromboxane as well as an increase in vascular sensitivity to angiotensin II.

Angiotensin II is a natural substance which is responsible for the narrowing of the blood vessels. In addition, placental ischemia also leads to reduced formation of vasodilators like prostacyclin and nitric oxide. These aspects result to increased blood pressure due to arterial wall resistance.

Pregnancy Induced Hypertension Treatment

The treatment of pregnancy-induced hypertension depends on its severity and it essential that you consult your doctor and follow the instructions given to manage it. A mild PIH may be treated at home with close monitoring by a physician. If you have been recommended by your doctor to manage the condition at home, you really need to have quiet and restful environment and reduce the frequency and intensity of activities.

You also need to have bed rest on your left side. The fetal movement should also be monitored and if you notice any changes, you should report to the doctor immediately. You should also follow the diet and fluid intake guidelines as provided by the doctor. However, if the condition worsened, you may be admitted to hospital for close monitoring.

The doctor provides treatment that is best suited for you and the baby. Medication is administered and magnesium is given through an IV as this helps prevent seizures. Salt intake is an aspect which needs to be discussed with your doctor. In other forms of hypertension, the amount of salt intake may be reduced significantly but during pregnancy, salt intake to normal amounts is important as it helps in fluid retentions in the body.

In essence, pregnancy-induced hypertension can prevent the placenta from receiving sufficient blood for supply of nutrients and oxygen. This can cause low birth weight in your baby. Other complications which may be caused by the condition are placental disruption in which the placenta pulls away from the uterus wall and this can cause bleeding and fetal distress. The PIH can also cause seizures in the mothers and blood clotting problems. It may also result to delivery of premature baby.

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