GPHC health corner … Gestational Hypertension and Pre-eclampsia

Oct 29, 2013 News

During routine pregnancy care, all pregnant women should have their blood pressure taken at each visit.  When high blood pressure (also known as hypertension) first occurs in the second half of pregnancy, it is known as gestational hypertension.
A blood pressure of 140/90 or higher is considered high blood pressure in pregnancy.  Gestational hypertension normally goes away within six weeks of the baby being born.  If you have gestational hypertension, you will need to see a doctor who specializes in Obstetric care and have your blood pressure checked more frequently.
When a woman with gestational hypertension starts to have other complaints, she then has a more serious condition called pre-eclampsia. Pre-eclampsia can affect all organs of the body.  It can cause stress on the kidneys, leading to protein in the woman’s urine.
Other signs of pre-eclampsia include headaches, visual problems, severe abdominal pain, rapid weight gain, swelling (oedema) of the hands and face, or sudden nausea or vomiting in the later part of pregnancy. It can also affect the health of the baby in the womb.
Scientists are not sure why some women get pre-eclampsia, but we do know some women are more likely to get it than others: women who are currently in their first pregnancy, have high blood pressure before pregnancy, are under age 20 over age 35, have had pre-eclampsia in the past, are currently pregnant with more than one baby (twins, triplets), have certain medical conditions such as diabetes or kidney disease, are obese, or have certain immune disorders such as lupus.
Once a woman has pre eclampsia it does not go away until after the birth of the baby. We can use medication to control her blood pressure but the condition stays and can get worse until the pregnancy is ended.  Because it can get worse, for the mother or baby, at any time, a woman with pre-eclampsia needs closer monitoring during her pregnancy.  She may even need to stay in the hospital until the baby is delivered.
When she is in hospital the doctors and nurses will check her blood pressure several times a day and do blood tests, ultrasounds and heart rate monitoring for the baby to make sure her condition is not getting worse. When pre-eclampsia becomes severe, damage can occur to the woman’s kidneys, liver, brain, heart and eyes.
The placenta (afterbirth) can also be damaged affecting the babies growth or separate early (placental abruption), needing emergency delivery. In some cases, fits or seizures will occur. This is called eclampsia.  If these conditions are left untreated they may lead to death of the mother or her baby, so
Once they are detected, plans must be made to deliver the baby.  However this is not always an easy decision.  If babies are born too early they can have complications such as difficulty with breathing, bleeding in their brain or damage to their intestines.  So the doctors need to weigh up the health of the mother and her baby.  Sometimes they may try to hold off delivery to give the mother some injections to protect the baby.
When planning how to deliver the baby, most women can have a normal delivery.  A severe form of pre-eclampsia can lead to lots of bleeding so Cesarean sections are usually only done if there is immediate stress for the baby.  The doctors might have to induce labour with medication. If the mother has severe pre-eclampsia she will be given-medication through a drip to prevent fits.
This drip is continued for one day after the baby is born.  After the baby is born sometimes the pre-eclampsia can get worse before it gets better.  Sometimes it is detected for the first time after the baby is born.  Patients who had pre-eclampsia still need close blood pressure monitoring after delivery and may need to take blood pressure medications for several weeks after the birth.  All women with pre-eclampsia stay in hospital for further observation at least 3 days after the baby is born.
Because of the potentially tragic outcomes of pre-eclampsia it is very important to seek medical attention as soon as possible if you or one of your friends or family who is pregnant, has any of these complaints.  In addition, if diagnosed, even if you feel well, it is essential to follow medical advice and close monitoring throughout pregnancy for the best possible outcome in you and your baby.