Friday, February 28, 2014

Keep It Down!

I want to discuss pregnancy induced hypertension (PIH).  It is something that is not necessarily a main concern initially when you are going through your prenatal visits.  It becomes a greater issue typically in the third trimester.  Questions I have been asked recently because of my experience are, “What is gestational hypertension?” “What is pregnancy induced hypertension?” What is preeclampsia?” “How do you get it?” “How can I prevent it?” “How will I know if I have it?”  I am going to answer all these questions and then some.

Hypertension is high blood pressure.  Blood pressure is the pressure of blood pushing against blood vessel walls.  When the force of the blood is above normal (120/80) this is considered high blood pressure.  Pregnancy induced hypertension (PIH) is high blood pressure accompanied by headaches, swelling in the face, feet and hands and protein in your urine.  PIH is also called preeclampsia, and toxemia.

There are certain factors that make you more at risk for PIH.  Being under the age of 20 or over the age of 35, being underweight or overweight, a history of hypertension, a history of PIH, a mother, sister, aunt or grandmother with a history of PIH or hypertension, kidney disease, immune disorder, and expecting multiples are all reasons you may be at higher risk.

If you experience any of the following immediately call your doctor or midwife:
-Swelling in the face, feet and/or hands
-Severe headaches accompanied by spots, dizziness and changes in vision
-Reduced urination or blood in the urine
-Flank or abdominal pain
-Vomiting and nausea
-Decreased fetal movement
These are all symptoms of PIH.

When you go to your prenatal visits your doctor or midwife will most likely take a urine sample and be testing routinely to see if there is any protein in your urine.  At every visit they also will check your blood pressure and weight.  If you have rapid weight gain, a high blood pressure and protein in the urine your doctor will order further testing for you and the baby.  There is question of high blood pressure when the systolic (above number) is between 120 and 139 and the diastolic (below number) is between 80 and 89, this is considered prehypertension.  Sometimes “office anxiety” kicks in and you temporarily have a higher read so in some cases it is best to ask your doctor to do another reading.  I had to get mine read at the beginning and end of my doctor appointments.

If PIH begins to get worse the only cure is to deliver the baby.  I remember being admitted to the hospital at 34 weeks and I was given magnesium to prevent any seizures and medication for the blood pressure.  At this point doctors and midwives need to look and see if the benefits outweigh the risk of using medication.  Make sure you do not hesitate to call your doctor or midwife if you are experiencing any of the above symptoms.

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