Preeclampsia Case Study

Topics: Obstetrics, Hypertension, Pre-eclampsia Pages: 5 (1049 words) Published: October 1, 2011
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. Gestational hypertension replaces the PIH and is used for hypertensive disorders that are specifically associated with pregnancy, pre-eclampsia and eclampsia. It has long been one of the major problems for mothers in pregnancy, along with infection and postpartum hemorrhage. There exist several hypertensive states of pregnancy:

• Gestational hypertension = usually defined as a BP over 140/90 without the presence of protein in the urine. • Preeclampsia = gestational hypertension (BP > 140/90), and proteinuria (>300 mg of protein in a 24-hour urine sample). Severe preeclampsia involves a BP over 160/110 (with additional signs) • Eclampsia = seizures in a preeclamptic patient

• HELLP syndrome = Hemolytic anemia, elevated liver enzymes and low platelet count • Acute fatty liver of pregnancy is sometimes included in the preeclamptic spectrum. • Pre-eclampsia and eclampsia are sometimes treated as components of a common syndrome. INCIDENCE:

- Preeclampsia affects 5-8% of all pregnancies but 10-20% of mothers will have a hypertensive disorder during pregnancy. - Occur in 5-7 % of all pregnancies.
- Seen more often to primigravidas, teenagers of low socioeconomic class. - May be related to decrease production of bsome vasodilating prostaglandins, vasospasm occurs. - Onset after 20th week of pregnancy may appear in labor or up to 48 hrs postpartum cause essentially unknown.

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
• Primigravida
• Obesity

What are the symptoms of PIH?

Rapid or sudden

-Weight gain, 4 - 5 lbs in a single week
-high blood pressure,
-protein in the urine,
- Swelling (in the hands, feet, and face) 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 under your ribs, 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...
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