Pregnancy-induced hypertension

What is preeclampsia?

When after the twentieth week of pregnancy, pregnant has high blood pressure, fluid retention with the onset of edema and protein loss in the urine, the condition known as preeclampsia is triggered.

They not always happen the three groups of symptoms and clinical signs. It is a picture that requires a very strict obstetric care and sometimes can lead, if not properly controlled, to a cataclysmic picture with serious danger to the mother and fetus.

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Why preeclampsia occurs?

Although the underlying causes are unknown, it seems to be because there is mismatching of the uterus to the placental system, which causes the production of a number of substances that will increase the resistance of vessels and therefore decrease arteriovenous flow to the fetus.

There are conditions that increase the risk of developing preeclampsia frequency:

• The first pregnancy
• The diabetes , both as pre-pregnancy gestational diabetes
• Prior essential hypertension
• Chronic kidney disease
• Previous pregnancy with hypertension induced by pregnancy
• Multiple gestations.

Know more

Do you want to know more? See our 'section Women's Health ',' Pregnancy & Childbirth 'and there are numerous related articles.

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What are the symptoms?

Various levels of preeclampsia in terms of signs and symptoms, and severity thereof:

Most symptoms disappear within hours or days of termination of pregnancy, rarely boxes hypertension and preeclampsia may occur in the immediate postpartum period, but when they occur are even more dangerous because it is no longer thought them both.

• Elevated blood pressure. When a rise in blood pressure occurs above 140/90 mmHg in at least two serial measurements, with the patient at rest, or when an increase in systolic (maximum) blood pressure above 15 mmHg occurs, or 10 mmHg in diastolic (minimum).
• Very high pressure values ​​(above 170/110) are authentic pictures of fetal maternal severity and are usually accompanied by other symptoms such as severe headache, pain in the abdominal area, view of flashing lights, etc.
• High urine protein level. In normal pregnancy urine protein figures are high; in the tables of pregnancy-induced hypertension, these losses are higher and facilitate the development of edema in the distal part of the lower extremities, upper extremities edema, facial edema, etc.
• Epigastric pain is a warning sign, and is caused by the loosening of the cover surrounding the liver. Always accompanied by changes in the production of clotting factors, a fact which further complicates the picture that represents this serious disease.

Treatment

There are different types of drug therapy:

• Rest and sedation will be the first step to try to control blood pressure; if mild not require hospitalization, maternal and fetal monitoring will be made within the periods established by the obstetrician.
• When the picture is moderate or severe, a number of antihypertensive drugs do not reduce the uteroplacental flow, which could be detrimental to the welfare of the fetus will be used. drugs that accelerate lung maturity, if necessary terminate the pregnancy before the end shall be used.
• You should never use diuretics or diets are made without salt.
• When the fetal lung maturity has been established, pregnancy will end with an induction to birth vaginally face if possible, or by performing a cesarean when circumstances require.

Prophylaxis

It is essential to think about this disease in pregnant When One of the risk factors discussed above.

Monitoring of blood pressure in pregnant the OB with each visit will help us to early diagnosis and the establishment of appropriate control measures.

It has been shown how early administration of antiplatelet type of aspirin also reduce the incidence of preeclampsia. Diets high in calcium , high protein and rich in vitamin C , antioxidants also appear to reduce the incidence of this disease.

Dr. Vibeke Manniche. , specialist in pediatrics; Dr. Philip Owen , a specialist in Obstetrics and Gynecology