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Pregnancy Induced Hypertension (PIH)

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) which carry the blood throughout the body. High blood pressure, also called hypertension, means the pressure in your arteries is above the normal range.

What is pregnancy-induced hypertension?

Pregnancy-induced hypertension (which may also be called preeclampsia or toxemia) is a pregnancy complication characterized by high blood pressure, swelling due to fluid retention and abnormal kidney function.

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 later pregnancies. Many times, PIH develops during the last trimester of pregnancy, 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 family history of PIH
  • Is underweight or overweight
  • Has high blood pressure before becoming pregnant
  • Has diabetes before becoming pregnant
  • Has an immune system disorder, such as lupus
  • Has kidney disease
  • Has a history of alcohol, drug or tobacco use
  • Has a multiple pregnancy (is expecting more than one fetus, such as twins or triplets)

How is PIH diagnosed?

During routine prenatal tests, your weight gain, blood pressure and urine protein are monitored. Rapid or sudden weight gain, high blood pressure, protein in the urine, as well as swelling in the hands, feet and face are all signs of PIH. Additional blood tests may also be ordered, which would show abnormal results if PIH is present.

If PIH is suspected, a non-stress test may be performed. During the nonstress 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 which 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.

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. It is important that you follow the diet and fluid intake guidelines from your health care provider and maintain your scheduled Clinic appointments. Your constant perception of fetal movement 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.

What is the danger of PIH?

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.
  • Seizures
  • 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
  • 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
  • Blurry vision
  • 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.