Overview of high blood pressure in pregnancy
As it was noticed in our previous article, PIH, also called high blood pressure during pregnancy, is a potentially life-threatening disorder that usually develops after the 20th week of pregnancy. It occurs most commonly in nulliparous women. Currently, PIH and its complications are the most common cause of maternal and fetal death in developed countries.
With or without seizure
PIH is typically classified as preeclampsia or eclampsia. Preeclampsia is the non-convulsive form of disorder, is marked by the onset of hypertension after 20 weeks of gestation. It develops in about 7% of pregnancies and may be mild or severe. The incidence is significantly higher in patients from low socio-economic groups. About 5% of women with high blood pressure in pregnancy develop into eclampsia; of these, about 15% die of eclampsia or its complications. Fetal mortality is high because of the increased incidence of premature delivery.
Complicating the situation
Generalized arteriolar constriction of the vessels which is associated with PIH is thought to produce decreased blood flow through the placenta and maternal organs. This can result in intrauterine growth retardation (or restriction), problems with the placenta and hemolysis. There will be an elevation of enzyme level for liver and low platelet count (HELLP Syndrome). It is associated with severe preeclampsia. Other possible complications include stillbirth of the neonate, seizures, coma, premature labor, renal failure, and liver damage in the mother.
Causation of pregnancy and high blood pressure
Although the points about what effects blood pressure and high blood pressure is unknown, systemic spasm of the vessels can occur. This will affect every organ systems of the body. The geographic, ethnic, racial, nutritional, immunological, and familial factors may contribute to preexisting problems with the vessels which in turn, may contribute to its occurrence. Age is also a factor about what effects blood pressure and high blood pressure. Adolescence and first time mothers who are older than age 35 are at higher risk for preeclampsia.
Other possible causes includes potential toxic sources (such as problems with the placenta), maternal sensitization to the total proteins, disorders in the kidney causing inflammation of the bladder are connected to what effects blood pressure and high blood pressure.
Common manifestations of and high blood pressure during pregnancy symptoms
The high blood pressure and pregnancy period comes along when a pregnant mother reports a sudden weight gain of more than 3 lb (1.4kg) per week during the third trimester. The mother’s history reveals high blood pressure during pregnancy, as evidenced by high readings (140 mmHg or more for systolic, or an increase of 30mmHg or more above the patients normal systolic pressure, measured on two occasions, 6 hours apart; and 90 mmHg or more diastolic, or an increase of 15 mmHg or more above the patient’s normal diastolic pressure, measured on two occasions, 6 hours apart). Further examination may reveal generalized edema, especially of the face. Palpation may reveal pitting edema of the legs and feet. Deep tendon reflex may indicate hyperreflexia.
As preeclampsia worsens, the patient may demonstrate oliguria (urine output of 400 ml per day or less), blurred vision caused by spasms of the retina, Epigastric pain or heartburn, irritability, and emotional tension. She may also complain of a severe frontal headache.
In severe high blood pressure in pregnants, blood pressure readings increase to 160/110 mmHg or higher on two occasions, 6 hours apart, during bed rest. Ophthalmoscopy examination may reveal spasms of the vessel, edema of the eyes and retina, possible signs and symptoms of retinal detachment, and vein nicking or hemorrhage.
The onset of seizures signifies eclampsia. The patient with eclampsia may appear to cease breathing, then suddenly take a deep, gasping breath and resume breathing. High blood pressure and pregnancy stage occurs to women that may possibly suffer from lapse into coma, lasting a few minutes to several hours. When waking from the coma, the pregnant mother may have no memory of the seizure. Mild eclampsia may involve more than one seizure; severe eclampsia up to 20 seizures.
In eclampsia, the physical examination findings are similar to those in preeclampsia but more severe. The systolic blood pressure may increase to 180 mmHg or even 200 mmHg. Marked edema may be present; some pregnant mothers, however, don’t show visible signs of edema.
Prescribe treatment for preeclampsia
The high blood pressure and pregnancy condition requires adequate nutrition, good prenatal care, and control of preexisting hypertension during pregnancy period. This will help lessen the incidence and severity of preeclampsia. However, if preeclampsia does develop, early recognition and prompt treatment can prevent the progression of the condition.
If these measures fail to improve the pregnant mother’s condition, or if fetal life is endangered (as determined by stress of non-stress tests and biophysical profile), caesarean deliver or labor induction with oxytocin may be required. If the woman develops seizures, emergency treatment consists of IV fluids of magnesium will be administered.