Pregnancy Induced Hypertension
Alternative names :- Toxemia, Preeclampsia
Pregnancy-induced hypertension (PIH), also known - although incorrectly - as toxemia of pregnancy, is a potentially life-threatening disorder that usually develops late in the second trimester or in the third trimester. Preeclampsia, the non convulsive form of PIH, develops in about 7% of pregnancies. Preeclampsia may be mild or severe, and the incidence is significantly higher in low socioeconomic groups. Eclampsia is the convulsive form of PIH. About 5 % of females with preeclampsia develop eclampsia; of these, about 15 % die from PIH itself or its complications. I Fetal mortality is high due to the increased incidence of premature delivery and uteroplacental insufficiency.
Causes of Pregnancy Induced Hypertension
The cause of PIH is unknown; however, geographic, ethnic, racial, nutritional, inmtunologic, and familial factors as well as preexisting cardiovascular disease (such as diabetes mellitus, hypertension, and hyperlipidemia) may contribute to its development. Age is also a risk factor for PIH. Printiparas over age 35 and those women with large placentas from multiple pregnancies are at higher risk for preeclampsia.
Signs and symptoms of Pregnancy Induced Hypertension
Mild preeclampsia generally produces:
Severe preeclampsia is marked by increased hypertension and proteinuria, eventually leading to the devel. opment of oliguria. HELLP syndrome (hemolysis, elevated liver enzymes, and low platelets) is a severe variant of preeclampsia. Other symptoms that may indicate worsening preeclampsia include blurred vision due to retinal arteriolar spasms, epigastric pain or heartburn, and severe frontal headache.
In eclampsia, all the clinical manifestations of preeclampsia are magnified and are associated with seizures and, possibly, coma, premature labor, stillbirth, renal failure, and hepatic damage.
Diagnosis of Pregnancy Induced Hypertension includes:
The following findings suggest mild preeclampsia:
Typical clinical features especially seizures with typical findings for severe preeclampsia strongly suggest eclampsia. Ophthalmoscopic examination may reveal vascular spasm, papilledema, retinal edema or detachment, and arteriovenous nicking or hemorrhage.
Real-time ultrasonography, stress and nonstress tests, and biophysical profiles evaluate fetal status. In the stress test, oxytocin is administered to stimulate contractions and then fetal heart tones are monitored electronically. In the non stress test, fetal heart tones are monitored electronically during periods of fetal activity without oxytocin stimulation. Electronic monitoring reveals stable or increased fetal heart tones during periods of fetal activity.
Ultrasonography aids evaluation of fetal health by assessing fetal breathing movements, gross body movements, fetal tone, reactive fetal heart rate, and qualitative amniotic fluid volume.
Pregnancy Induced Hypertension treatment
Therapy for preeclampsia is designed to halt the disorder's progress specifically, the early effects of eclampsia, such as seizures, residual hypertension, and renal shutdown and ensure fetal survival. Some physicians advocate the prompt induction of labor, especially if the patient is near term; others may take a more conservative approach. Therapy may include anticonvulsants (such as magnesium sulfate), along with complete bed rest, to relieve anxiety, reduce hypertension, and evaluate response to therapy. Antihypertensive therapy doesn't alter the potential for developing eclampsia. Diuretics aren't appropriate during pregnancy.
If the patient's blood pressure fails to respond to bed rest and sedation and persistently rises above 160/ 100 mm Hg, or if CNS irritability increases, magnesium sulfate may produce general sedation, promote diuresis, and prevent seizures. Cesarean birth or oxytocin induction may be required to terminate the pregnancy.
Emergency treatment of eclamptic seizures consists of immediate administration of magnesium sulfate I.V., oxygen administration, and continuous electronic fetal monitoring. After the seizures subside and the patient's condition stabilizes, delivery should proceed with induction of labor or cesarean birth, depending on the circumstances.
Pregnancy Induced Hypertension Complications
Pregnancy induced hypertension may develop into eclampsia , the occurrence of seizures. Fetal complications may occur because of prematurity at time of delivery.
Cosmetics Home || Beauty & Cosmetics Articles || Contact Us || Cosmetics Shopping
(c)Copyright Bestincosmetics.com All rights reserved.