|Birth||Postnatal||Childhood Illness||Glossary A-Z|
Blood pressure (BP) problems, hypertension (BP too high) and hypotension (BP too low), are one of the most common reasons women are admitted to the hospital antenatal ward. High-tension is a common finding in early and mid-pregnancy and is, by and large, nothing to worry about. There are various types of high blood pressure problems in pregnancy. These include:
1. Chronic hypertension . This type of hypertension was present even before the woman was pregnant.
2. Pregnancy-induced hypertension (PIH).
This type of hypertension is similar to the chronic type, but it first
displays when a woman is pregnant and resolves completely after delivery.
A proportion of women with PIH will go on to develop pre-eclampsia; unfortunately
we cannot predict who it will be. Also, women who have PIH are at greater
risk of developing hypertension later in life.
3. Pre-eclampsia. Pre-eclampsia is a disease
unique to pregnancy. Pre-eclampsia is more likely to happen in a second
pregnancy if one has suffered it before. Mild pre-eclampsia at term is
less likely to recur (5-10%) and when it does, it's usually mild again.
After severe pre-eclampsia, recurrence rate is about 20-25% in subsequent
pregnancies. After eclampsia, about 25-30% of subsequent pregnancies will
be complicated by pre-eclampsia, but only 2% with eclampsia again. Chronic
hypertension is more common after pre-eclampsia, affecting about 15%
at 2 years. It is more likely after eclampsia or severe pre-eclampsia
(especially if recurrent or occurring during the 2nd trimester), affecting
30-50% of women.
Certain factors may make development of pre-eclampsia more likely.
Signs and Symptoms
Pre-eclampsia is characterised, not only by high BP, but also proteinuria
(protein in the urine) caused by 'leaky' kidneys. However, pre-eclampsia
doesn't just affect the BP and kidneys, it affects almost every organ
system of the body. In the milder forms it might just be the kidneys that
are affected to any serious degree, hence proteinuria is the only other
Diagnosis and Treatment
In addition to high blood pressure, the other main screening test is to check the urine for signs of proteinuria.
Ultimately the only treatment is delivery of the baby. This may be fine if a woman is, say, 38 weeks gestation, but at 30 weeks, it becomes much more of a dilemma. In the later stages of pregnancy it is normal to induce labour, but early on if delivery is decided upon, caesarean section is more usual. It's an individual decision and must be tailored to the patient and her disease severity.
For mild to moderate pre-eclampsia when a woman is prior to term, admission to hospital is needed and assessment of the severity of the disease carried out. In addition to regular examinations, the following tests are commonly arranged in order to assess severity and progression of the pre-eclampsia:
The information in this page is presented in summarised form and has been taken
from the following source(s):
|http://www.hon.ch/Dossier/MotherChild/complications/complicate_eclampsia.html||Last modified: Jun 25 2002|