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Pregnancy-Induced Hypertension

What is high blood pressure?

Blood pressure is the force of blood pushing against blood vessel walls. The heart pumps blood into the arteries (blood vessels) that carry the blood throughout the body. High blood pressure, also called hypertension, means that the pressure in the arteries is above the normal range.

What is pregnancy-induced hypertension?

Pregnancy-induced hypertension—which may also be called pre-eclampsia, toxemia, or toxemia of pregnancy—is a pregnancy complication characterized by high blood pressure, swelling due to fluid retention, and protein in the urine.

Who is affected by PIH?

Pregnancy-induced hypertension (PIH) affects approximately one out of every 14 pregnant women. Although PIH more commonly occurs during first pregnancies, it can also occur in subsequent pregnancies. PIH is also more common in pregnant teens and in women over age 40. Many times, PIH develops during the second half of pregnancy, usually after the 20th week, but it can also develop at the time of delivery or right after delivery.

Who is at risk of developing PIH?

A woman is more likely to develop PIH if she:

  • Is under age 20 or over age 35
  • Has a history of chronic hypertension
  • Has a previous history of PIH
  • Has a female relative with a history of PIH
  • Is underweight or overweight
  • Has diabetes before becoming pregnant
  • Has an immune system disorder, such as lupus or rheumatoid arthritis
  • Has kidney disease
  • Has a history of alcohol, drug, or tobacco use
  • Is expecting twins or triplets

What are the symptoms of PIH?

Rapid or sudden weight gain, high blood pressure, protein in the urine, and swelling (in the hands, feet, and face) are all signs of PIH. Some swelling is normal during pregnancy. However, if the swelling doesn't go away and is accompanied by some of the above symptoms, be sure to see your doctor right away. Other symptoms of PIH include abdominal pain, severe headaches, a change in reflexes, spots before your eyes, reduced output of urine or no urine, blood in the urine, dizziness, or excessive vomiting and nausea.

How is PIH diagnosed?

During routine prenatal tests, your weight gain, blood pressure and urine protein are monitored. If you have symptoms of PIH, as listed above, additional blood tests may be ordered, which would show abnormal results if PIH is present.

If PIH is suspected, a non-stress test may be performed to monitor the baby. During the non-stress test, an ultrasound transducer records the baby's heart rate, and a pressure transducer (called the toco transducer) records uterine activity. Each time you feel the baby move, you make a mark on a graph paper that displays the fetal heart rate and uterine activity.

Usually the fetal heart rate increases when the fetus moves, just as your heart beats faster when you exercise. Certain changes in the fetal heart rate are considered a sign of good health. Sometimes an ultrasound provides more information about the baby.

How is PIH treated?

If PIH is mild, it can be treated at home. If you have been diagnosed with PIH and your doctor recommends home treatment, you will need to maintain a quiet, restful environment with limited activity or bed rest on your left side.

It is important that you follow the diet and fluid intake guidelines from your health care provider and maintain your scheduled appointments. Your perception of fetal movement every three hours is also important. Any changes need to be reported to your health care provider immediately.

If PIH becomes worse, you will need to be admitted to the hospital where you can be closely monitored. Your health care provider will work with you to maintain the health of you and your baby. In severe cases, the baby may have to be delivered. High blood pressure is treated with medication, and magnesium is given through an IV to prevent seizures.

What is the danger of PIH?

PIH can prevent the placenta from receiving enough blood, which can cause low birth weight in your baby. Although these complications are rare, PIH may cause the following:

  • Placental abruption, a complication that occurs when the placenta pulls away from the wall of the uterus, causing maternal bleeding and fetal distress
  • Seizures in the mother
  • Temporary kidney failure
  • Liver problems
  • Blood clotting problems
  • Early delivery of premature baby

When should I call my health care provider?

It is important to call your health care provider right away if you notice any of the following:

  • Rapid weight gain (5 pounds in 5 days)
  • Swelling or puffiness in your fingers, feet, face, or eyelids
  • Numbness in your hands or feet
  • Headache that is not relieved by taking acetaminophen (Tylenol®)
  • Abdominal pain, especially in the upper abdomen or to the right
  • Blurry vision, spots before your eyes that don’t resolve
  • Ringing in your ears
  • Decrease in fetal movement
  • Uterine contractions
  • Unrelieved nausea or vomiting
  • Vaginal bleeding
  • Any other symptom that causes concern

Does PIH improve after delivery?

A woman's blood pressure usually returns to normal after delivery. Sometimes, however, blood pressure may remain high, requiring treatment with medication. Your health care provider will work with you after your pregnancy to prescribe an appropriate medication.

References

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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 12/8/2013... index#4497


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