Pregnancy-Induced Hypertension (PIH)


 

Pregnancy-Induced Hypertension (PIH)

If you are pregnant and have been detected with high blood pressure readings on more than one occasion, don’t ignore it. Remember that if you have pregnancy induced hypertension (PIH) and it is left untreated, there are high chances of you winding up with a preterm baby, a still born baby, or a baby with growth retardation not to mention the effects on your health.

Sounds serious, isn’t it? But rest assured. Not only can PIH be detected early during regular antenatal visits but there are treatment options that can help in controlling your blood pressure and help prevent serious complications.

Understanding PIH

Pregnancy induced hypertension (PIH) refers to the high blood pressure disorders seen in pregnancy. The four different levels of hypertensive disorders in pregnancy are chronic hypertension (high blood pressure present for some time before pregnancy and detected prior to 20 weeks of gestation), gestational hypertension (high blood pressure during the second half of pregnancy), preeclampsia (high blood pressure affecting all organs of the body), and eclampsia (occurrence of seizures due to severe preeclampsia).

Reasons why you develop PIH could be attributed to preexisting high blood pressure, placental involvement, underlying disease, or hormonal factors. In simpler terms, you have PIH, if during pregnancy your blood pressure goes up, you retain water, and there is presence of protein in your urine.

You are at an increased risk of PIH, if you have a past history of high blood pressure or kidney disease. It is seen to be more common during your first pregnancy. You are also at an increased risk if your mother or sister had PIH. Your risk of PIH is increased if you are a teenage mother, or are over 40 years of age, and are carrying multiple babies.

Symptoms

If you are developing PIH you may be able to notice some symptoms. You may gain weight rapidly almost 4 to 5 lbs in a week. You may experience severe headaches, blurry vision, spots in your eyes, and severe pain over your stomach under your ribs, with decrease in your daily urine output. However, it is very likely that you may miss these symptoms and mistake them as normal worries of pregnancy. It is, therefore, very important that you keep your regular prenatal appointments wherein your doctor will screen you for any overt signs and aid in early detection of PIH.

Diagnosis

There is no one test that can detect or confirm whether you are suffering from PIH. Your doctor will look for signs of high blood pressure (140/90 mm Hg or greater on more than two occasions), persistent swelling over your face, ankles and feet, with rapid weight gain of over 4 to 5 pounds in a week. However, none of these symptoms as a standalone are indicative of PIH.

Your doctor may order for a urine test to look for the presence of and amount of protein in your urine. Your doctor may also order for blood tests to assess your kidney and liver functions, and clotting factors. Fetal ultrasound (high-frequency sound waves that create images of your baby on a monitor) may be recommended for close monitoring of your baby’s growth.  ADoppler scan will additionally help to measure efficiency of blood flow to the placenta. In order to ensure that your baby is getting enough oxygen and nourishment, a non stress testmay be done to check how your baby’s heart rate reacts when your baby moves.

Treatment

Your doctor will decide on the best option of management of your PIH based on how close you are to your due date. If you are close to your due date then the best way to protect you and your baby is delivery of your baby as soon as possible.  If PIH is detected very early in your pregnancy, management may include bed rest, lying on your left side (to take the weight off your major blood vessels), salt restriction, and medicines to lower your blood pressure until delivery of your baby. Your physician may also prescribe aspirin and calcium supplements to prevent complications of PIH.

If you are having severe preeclampsia your doctor will prescribe corticosteroids to temporarily improve your liver and platelet functioning and also to help your baby’s lungs become more mature (prepares a premature baby for its life outside the womb in as little as 48 hours). The most important part of your management is to see your doctor regularly to check your blood pressure, urine protein levels and your baby’s well being.

On the other hand, if your PIH is severe and you are almost close to your due date your doctor may recommend induction of labor right away. Whether you will have a normal labor or a caesarean section will depend on the readiness of your cervix (whether it’s beginning to open, thin out, and soften). If the PIH or preeclampsia is severe, and there is need to deliver your baby immediately it may not be possible to consider your baby’s gestational age or the readiness of your cervix. If your doctor feels that it is not possible to wait then he/she may induce labor in you or schedule a C-section at the earliest.

Complications

PIH can affect both you and your baby. High blood pressure prevents the placenta (that gives air and food to your baby) from getting enough blood resulting in your baby getting less air and food. This affects your baby and can cause premature birth, low birth weight, and still birth.

High blood pressure may affect your kidneys and other organs. If you develop the more serious form known as preeclampsia, it can affect the placenta, your kidneys, liver and brain. You may experience seizures due to its effects on your brain.  You may have to deliver prematurely due to the complications and risk to the baby and yourself. PIH has long lasting effects and also places you at a higher risk of developing coronary artery disease in the future.

Outlook

PIH is a serious illness that is characterized by high blood pressure during pregnancy. While many women with high blood pressure during pregnancy have healthy babies without serious problems, it can nevertheless be dangerous to both the mother and baby if left untreated. The positive side of PIH is that it can be detected early during regular antenatal visits. So, if you have developed PIH it is of great importance that you are followed closely by your medical practitioner to initiate appropriate treatment and help prevent prematurity/death of your baby and other severe complications. Treatment options range from dietary changes, exercise, rest, medicines, to deciding to deliver the baby in the most severe cases.  Always keep in mind that w

orking with your doctor to control your blood pressure level will help you in minimizing your risk and improve your chances of having a healthy baby.

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