PIH – PREGNANCY INDUCED HYPERTENSION
Pregnancy-induced hypertension (PIH) is a form of high blood pressure in pregnancy. Pregnancy-induced hypertension is also called toxemia or preeclampsia. It occurs most often in young women with a first pregnancy. It is more common in twin pregnancies, and in women who had PIH in a previous pregnancy.
Usually, there are three primary characteristics of this condition, including the following:
♦ high blood pressure (blood pressure reading higher than 140/90 mm Hg or a significant
increase in one or both pressures)
♦ protein in the urine
♦ edema (swelling)
Eclampsia is a severe form of pregnancy-induced hypertension. Women with eclampsia have seizures resulting from the condition. Eclampsia occurs in about one in 1,600 pregnancies and develops near the end of pregnancy, in most cases. HELLP syndrome is a complication of severe preeclampsia or eclampsia. HELLP syndrome is a group of physical changes including the breakdown of red blood cells, changes in the liver, and low platelets (cells found in the blood that are needed to help the blood to clot in order to control bleeding). The cause of PIH is unknown. Some conditions may increase the risk of developing PIH, including
♦ pre-existing hypertension (high blood pressure)
♦ kidney disease
♦ PIH with a previous pregnancy
♦ mothers age younger than 20 or older than 40 multiple fetuses (twins, triplets) The following are the most common symptoms of high blood pressure in pregnancy. However, each woman may experience symptoms differently.
Symptoms may include:
increased blood pressure
protein in the urine edema (swelling)
sudden weight gain
visual changes such as blurred or double vision
right-sided upper abdominal pain or pain around the stomach
urinating small amounts
changes in liver or kidney function tests
Diagnosis is often based on the increase in blood pressure levels, but other symptoms may
help establish PIH as the diagnosis. Tests for pregnancy-induced hypertension may include the following:
blood pressure measurement
assessment of edema
frequent weight measurements
eye examination to check for retinal changes
liver and kidney function tests
blood clotting tests
Treatment for pregnancy-induced
hypertension: Specific treatment for pregnancy-induced hypertension will be determined by your physician based on:
1) extent of the disease
2) your tolerance for specific medications, procedures, or therapies
3) expectations for the course of the disease
4) your opinion or preference
5)The goal of treatment is to prevent the condition from becoming worse and to prevent it
from causing other complications. Treatment for pregnancy-induced hypertension (PIH) may
6)bed rest either at home or in the hospital may be recommended).
7)hospitalization (as specialized personnel and equipment may be necessary).
8)magnesium sulfate (or other antihypertensive medications for PIH).
9)fetal monitoring (to check the health of the fetus when the mother has PIH) may include:
10)fetal movement counting – keeping track of fetal kicks and movements. A change in the
number or frequency may mean the fetus is under stress.
11) non-stress testing – a test that measures the fetal heart rate in response to the fetus'
12)biophysical profile – a test that combines the nonstress test with an ultrasound to observe the
13)Doppler flow studies – a type of ultrasound that uses sound waves to measure the flow of
blood through a blood vessel.
continued laboratory testing of urine and blood (for changes that may signal worsening of
medications, called corticosteroids, that may help mature the lungs of the fetus (lung
immaturity is a major problem of premature babies).
delivery of the baby (if treatments do not control PIH or if the fetus or mother is in danger).
Cesarean delivery may be recommended, in some cases.
Prevention of pregnancy-induced
Early identification of women at risk for pregnancy-induced hypertension may help prevent some complications of the disease. Education about the warning symptoms is also important because early recognition may help women receive treatment and prevent worsening of the diseases.