Pregnancy Induced Hypertension
A woman with pregnancy induced hypertension (PIH) experiences high blood pressure and protein deposits are found in her urine. In most cases, this condition occurs after twenty weeks of pregnancy and is common among first time mothers, teenagers and old mothers above forty years and who have had multiple pregnancies.
Symptoms
- Rushes or spots on the face.
- Protein in the urine.
- Sudden weight gain
- Sharp pain in the stomach especially on upper right side and around the ribs
Treatment
The condition can be detected through urine tests that check protein levels in the urine and using a Doppler scan that monitors flow of blood in the placenta. If the PIH is mild, the doctor recommends less salt consumption and resting by lying on left side so as to suppress the weight of the baby acting on the blood vessels. For severe cases, the doctor may use medications such as a magnesium sulfate injection to lower the blood pressure. Other medications include methyldopa, labetalol, and calcium channel blockers. Among these medications, research has shown methyldopa is the best of all because it has very few side effects to both the mother and fetus (Seneviratne, 1998, p. 167).
Pre-Eclampsia
Pre-eclampsia is a form of pregnancy induced hypertension that is associated with presence of proteins in the urine commonly known as proteinuria. It occurs at about twenty weeks of pregnancy but it is mostly common beyond twenty four weeks. It affects women who are having their first pregnancy as well as those who get pregnant in the course of pre-existing hypertension conditions.
Diagnosis
The condition is characterized by a rise in blood pressure that can go above 140/90mmHg. It is usually diagnosed during a routine antenatal checkup and in some cases the condition may warrant admission of the patient for close monitoring. Medical researchers have not fully discovered the pathophysiology of pre-eclampsia. However, it is believed to be a placental disorder that could result from poor perfusion in the placenta. It could also result from poor nutrition and high body fat. The underlying effect is poor development of the fetus, which is normally smaller than usual, mainly due inadequate flow of blood in the placenta. Severe pre-eclampsia may be experienced by a pregnant woman who previously had a mild type of this disease. The most dangerous thing about this condition is that it often appears with little or no warning. The blood pressure rises to about 160/110mmHg and there is a high quantity of protein deposits in the urine. The patient may have one or a combination of the following symptoms: severe headache, blurred vision, epigastric sharp pain similar to a heartburn, nausea and vomiting, muscle twitching and swelling of limbs (Wickham, 2008, p. 212).
Treatment
Treatment for pre-eclampsia in particular focuses on the high blood pressure. Doctors usually advise bed rest and antihypertensive medication may be administered to lower the blood pressure if the patient is in critical condition. In cases where the patient has convulsions, drugs to counter convulsions may be given. Doctors believe the best treatment for pre-eclampsia is induced premature birth, which is usually done through caesarean section. The following medications are used for reducing blood pressure:
- Magnesium sulfate, which prevents the risk of developing eclampsia
- Calcium channel blockers
- Methyldopa
- Nifedipine
Methyldopa, which is administered orally, is considered the best medication among these since it has fewer side effects.
Eclampsia
One of the complications that could results from pre-eclampsia is where the pregnant woman develops seizures and eventually goes into coma. The symptoms for eclampsia are similar to those of pre-eclampsia. However, the most common symptom for eclampsia is seizures. The tests for both pre-eclampsia and eclampsia include, blood platelet count, protein check in the urine and kidney function analysis.
Treatment
An intravenous injection of magnesium sulfate helps to reduce the chances of seizures recurring. Other medications may also be given to manage the level of blood pressure. These medications include hydralazine and labetalol. Premature birth may also be induced by use of oxytocin or prostaglandins, which can induce labor pains and hence prepare the cervix for delivery.
Side Effects of the Various Medications
Magnesium sulfate has adverse effects on muscles, as it makes them to grow weaker. It may also cause dizziness and slow breathing. Hydralazine may cause loss of appetite, mild diarrhea and vomiting. He patient could experience severe side effects such as yellowing of eyes, irregular heartbeat, joint pains and swelling of the mouth. Labetalol could induce side effects such as nose stuffiness, fatigue, indigestion, wheezing, persistent cough, chest pains and yellowing of the eyes. Oxytocin’s side effects include abrupt uterus contraction, vomiting, heavy bleeding during childbirth and blood clotting problems. Calcium channel blockers could cause side effects such as reduced heart rate and constipation. The use of Nifedipine has been known to have side effects such as blurred vision, heartburn, swelling of gums and limbs and constipation (Lyall & Belfort, 2007, p. 250).
References
Lyall, F., & Belfort, M. A. (2007). Pre-eclampsia: Etiology and clinical practice. New York, NY: Cambridge University Press.
Seneviratne, H. (1998). Pregnancy induced hypertension. Himayatnagar, Hyderabad: Orient Longman.
Wickham, S. (2008). Midwifery: Best practice, volume 5. New York, NY: New York Press.