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Pregnancy and Blood Pressure

Routine blood pressure and urine protein check up during antenatal care are for the early detection of a condition known as pre-eclampsia, also known as Pregnancy Induced Hypertension (PIH) or toxemia.

Pre-eclampsia is a serious pregnancy disorder characterized by high maternal blood pressure, protein in the urine and severe fluid retention.

There is no cure for the condition, except delivery of the baby.

Risk Factors

  • First pregnancy or a new partner
  • Family History
  • Diabetes Mellitus
  • Multiple pregnancies
  • Obesity
  • Extremes of maternal age
  • Preexisting Hypertension
  • Hydatidiform mole (A relatively rare mass or tumor that can form within the uterus at the beginning of a pregnancy)
  • Hydrops Fetalis (Rh Disease)

The mother’s blood pressure usually returns to normal as soon as the baby is delivered.

Signs & Symptoms

Pre-eclampsia can be asymptomatic and may develop at any time after 20 weeks of pregnancy but commonly develops during the later stages of pregnancy.

Pre-eclampsia most commonly causes high blood pressure and protein in the urine. Some advanced symptoms include:

  • Hand and face swelling
  • Headache
  • Visual disturbance
  • Upper abdominal pain
  • Dizziness
  • Nausea & Vomiting

Complications for fetus

The placenta in the uterus is a special organ that allows oxygen and nutrients to pass from the mother’s bloodstream to the baby, and waste products (such as carbon dioxide) to pass from the baby’s bloodstream to the mother. In pre-eclampsia, blood flow to the placenta is obstructed. In severe cases, the baby can be gradually starved of oxygen and nutrients, which may affect its growth. All these lead to

  • Neonatal Asphyxia (low oxygen)
  • Neonatal Hypoglycemia (Low glucose)
  • Intrauterine Growth Restriction (Low birth weight)

This growth restriction threatens the life of the baby and it may be necessary to deliver the baby prematurely. Another serious complication of pre-eclampsia is abruption, which means the placenta separates from the uterine wall and the woman experiences vaginal bleeding and abdominal pain. This is a medical emergency.

Management

Since pre-eclampsia can be asymptomatic, regular antenatal check up is advised. Bed rest in early stages may control the situation; sometimes medication is needed to control blood pressure. But if the signs of toxemia and poor fetal growth persist, it will often be necessary to induce labor and deliver the baby early.