Pregnancy Induced Hypertension
High blood pressure in pregnant women is called pregnancy induced hypertension (PIH). Pregnancy induced hypertension may also be referred to as gestational hypertension. The condition of high blood pressure was not present in the mother prior to pregnancy. During early stages of pregnancy induced hypertension, there is no protein present in the mother’s urine.
Increased Risk of Pregnancy Induced Hypertension
Pregnancy induced hypertension occurs in approximately 1 out of every 14 pregnancies. Blood pressure is a measure of the force of blood pushing on the walls of blood vessels. During pregnancy induced hypertension, the force of blood on the arterial walls is greater than normal. This places stress on the maternal and fetal bodies and may result in birth complications.
Risk factors for pregnancy induced hypertension include:
- First pregnancy
- Maternal age below 20 or over 35
- Drinking water contamination, with PFOA
- Mother is not getting enough calcium
- Mother is very underweight or overweight
- Multiple gestation, such as twins or triplets
- Maternal diabetes prior to pregnancy
- Antidepressant use during pregnancy
- Placental abnormalities, such as placental ischemia or hyperplacentosis
- Maternal thrombophilia, where abnormal blood coagulation heightens thrombosis risk
- Maternal immune system disorders, such as rheumatoid arthritis or lupus
- Maternal kidney disease
- Maternal history of drug or alcohol abuse
- Personal history of chronic hypertension
- Family history of pregnancy induced hypertension
- African-American race
Types of Pregnancy Induced Hypertension
Several forms of hypertensive states during pregnancy may present as:
- Gestational Hypertension – This form of pregnancy induced hypertension occurs when the maternal blood pressure is higher than 140/90. It can only be diagnosed after 20 weeks of gestation. No protein is found in the urine during gestational hypertension. The hypertension symptoms disappear after delivery.
- Chronic Hypertension – Women that have a high blood pressure, defined as greater than 140/90, will carry their hypertension into pregnancy. Hypertension is present prior to 20 weeks gestation, and it does not go away after delivery.
- Pre-eclampsia or Toxemia – This type of pregnancy induced hypertension is only diagnosed after 20 weeks gestation. Blood pressure is higher than 140/90 and protein is present in the urine. Severe preeclampsia will present as a blood pressure of 160/110 or greater. If treated properly, maternal blood pressure will return to normal after delivery.
- Eclampsia – This is an extremely severe development of pregnancy induced hypertension and preeclampsia. It will cause maternal tonic-clonic seizures, which are a generalized seizure affecting the entire brain. The infant will need to be delivered even if adequate gestational age has not yet been reached. This is a fatal condition for both the mother and unborn child.
Symptoms of Pregnancy Induced Hypertension
Certain signs of pregnancy induced hypertension may be vague, but doctors look for:
- Any change in reflexes
- Severe headaches
- Seeing spots
- Sudden weight gain
- High blood pressure
- Abdominal pain
- Protein or blood in urine
- Little or no urine
- Intense nausea or vomiting
Diagnosis and Treatment of PIH
Obstetricians may diagnose a mother with pregnancy induced hypertension by checking for warning signs. Check-ups include frequent weight measurements, blood pressure readings, urine analysis, and assessment of edema or swelling. Blood clotting tests, retinal examinations, liver tests, and kidney tests are also common methods to identify pregnancy induced hypertension.
Treatment for pregnancy induced hypertension depends on individual factors. Overall health of the pregnancy, tolerance for medications, and progression of the pregnancy induced hypertension will contribute to selecting a treatment. Any treatment for pregnancy induced hypertension is meant to prevent the disease from worsening or causing additional medical concerns. There isn’t any way to alleviate the hypertension until the infant has been delivered.
Treatment options for pregnancy induced hypertension involve:
- Minimal consumption of salt
- Drinking at least 8 cups of water a day
- Bed rest
- Continued laboratory testing, to monitor the progression of pregnancy induced hypertension
- Fetal monitoring, including Doppler flow studies, fetal movement counting, non-stress testing, and biophysical profile
- Magnesium sulfate, an antihypertensive medication for pregnancy induced hypertension
- Corticosteroids to help fetal lung development
- Emergency delivery, possibly by C-section
Permanent Damage from PIH
If pregnancy induced hypertension is not diagnosed or treated properly, the placenta may not get enough blood. The infant may not receive adequate oxygen or food during pregnancy induced hypertension. This can lead to fetal underdevelopment, low birth weight, or death. The mother will also face a wide range of medical issues as a result of pregnancy induced hypertension. These issues include liver failure, kidney problems, seizures, pulmonary edemas, coma, and death.