Hypertension in pregnancy what is that? The pressure that the blood has inside the arteries is always expressed through two values: systolic pressure is the pressure that the blood has when the heart contracts, the diastolic pressure is the pressure in the arteries between two heart contractions.
When the values exceed 140 mm Hg for systolic blood pressure and 90 mm Hg for diastolic blood pressure, we speak of hypertension, this situation can lead to serious health problems, especially in pregnancy.
There are two types of hypertension in pregnancy: chronic hypertension and pregnancy-induced hypertension or gestational hypertension.
Chronic Hypertension
It pre-exists pregnancy and in general, the woman is already undergoing drug therapy to lower its values. Such therapies can usually be continued even during gestation, while those that could be harmful to the fetus must be replaced. Chronic hypertension does not resolve after delivery.
Gestational Hypertension
It is also called preeclampsia. It appears after the 20th week of pregnancy and can be accompanied by kidney involvement with loss of protein in the urine (proteinuria). This hypertension disappears after delivery. The risk factors for the development of preeclampsia are not very specific: having contracted a preeclamptic state in a previous pregnancy, having twin pregnancies, being affected by kidney disease, having diabetes, and aging over 40 years. It has increasing degrees of severity.
To identify it in time, it is advisable to undergo regular blood pressure measurements during monthly medical examinations; if appropriate, your doctor will recommend that you check your blood pressure regularly at home, possibly at the same time of the day.
Body weight gain should also be monitored regularly. The doctor will also request urine tests to look for the presence of protein.
Why Is Dangerous Hypertension In Pregnancy?
Hypertension is given by a narrowing of the caliber of the arteries, with the consequence that less blood reaches some organs in particular, and this also happens at the level of the placenta, which serves to provide the nourishment and oxygen necessary to the fetus, therefore it slows down the fetal growth, moreover, in some cases, it gives a detachment of the placenta, which manifests itself with a hemorrhage from the genitals, and which endangers the fetal life.
This also occurs for chronic hypertension, although it does not significantly aggravate the mother’s health conditions, while gestational hypertension also puts maternal health in serious danger:
- can damage various organs (kidneys, liver, brain, eyes),
- can weaken the heart,
- it can become complicated in a syndrome called HELLP, in which there is an increase in liver transaminases, a decrease in platelets, and a breakdown of red blood cells,
- can cause pulmonary edema,
- can lead to the consumption of clotting factors, causing severe bleeding at the time of delivery,
- in extreme cases, it triggers convulsions that can be so severe as to lead to maternal death
Treatment
Chronic hypertension can be treated by adjusting therapy with drugs that lower blood pressure according to the new needs and by adopting a low-salt diet, in some moments rest may be indicated, favoring the position of lying on the left side. Prenatal checks must be intensified, and ultrasound scans to verify the regularity of the fetus’ growth, its well-being must be checked by counting the fetal movements and undergoing cardiotocographic traces already from about the 30th week of pregnancy; delivery should take place within the 40th week of pregnancy to avoid possible complications.
The only real way to resolve preeclampsia is to deliver the birth before the situation is too serious for the mother and baby, and sometimes a cesarean section may be necessary. Generally, it expects to reach a gestational age that allows the newborn to have a good chance of survival, doing pressure therapies and prevent epileptic seizures, keeping the situation under control with hospitalization, frequent examinations on the mother, with ultrasound and cardiotocographic monitoring to assess the health of the fetus.
The pressure normalizes after a few days after delivery, but the first 24 hours after delivery are a very critical moment. with ultrasound and cardiotocographic monitoring to assess the health of the fetus. The pressure normalizes after a few days after delivery, but the first 24 hours after delivery are a very critical moment. with ultrasound and cardiotocographic monitoring to assess the health of the fetus. The pressure normalizes after a few days after delivery, but the first 24 hours after delivery are a very critical moment.
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