Introduction to Hypertensive Disorders in Pregnancy

Nowadays, many women suffer from high blood pressure during pregnancy. High blood pressure during pregnancy is very uncommon, but it always bothers patients, and many people do not understand what is going on and why there are symptoms of high blood pressure during pregnancy. So today I will introduce to you what it means to have high blood pressure during pregnancy.

Hypertensive disorders complicating pregnancy are diseases specific to pregnancy, including gestational hypertension, preeclampsia, eclampsia, chronic hypertension complicated by preeclampsia, and chronic hypertension. The incidence rate in my country is 9.4%, while that reported overseas is 7% to 12%. This disease seriously affects the health of mothers and infants and is one of the main causes of morbidity and mortality in pregnant women and perinatal infants. Hypertension, edema and proteinuria appear after 20 weeks of pregnancy. In mild cases, there may be no symptoms or mild dizziness, slightly increased blood pressure, accompanied by edema or mild proteinuria; in severe cases, there may be headache, dizziness, nausea, vomiting, persistent right upper abdominal pain, etc., with a significant increase in blood pressure, increased proteinuria, obvious edema, and even coma and convulsions.

The diagnosis can be made based on medical history, clinical manifestations, physical signs and auxiliary examinations, while paying attention to the presence of complications and coagulation mechanism disorders.

1. Hypertension during pregnancy

Blood pressure ≥18.7/12kPa (140/90mmHg), occurs during pregnancy and returns to normal within 12 weeks after delivery; urine protein is negative; there may be upper abdominal discomfort or thrombocytopenia. The diagnosis can only be made after delivery.

2. Preeclampsia

≥18.7/12 kPa (140/90 mmHg) and urine protein ≥300 mg/24 hours or (+) appear after 20 weeks of pregnancy. It may be accompanied by symptoms such as upper abdominal discomfort, headache, and blurred vision.

3. Eclampsia

Pregnant women with preeclampsia have seizures that cannot be explained by other reasons.

treat

1. General treatment

Rest, closely monitor the condition of mother and child, intermittent oxygen inhalation, diet including adequate protein and calories, unlimited salt and fluids, and appropriate salt restriction for those with systemic edema.

2. Antispasmodic

Magnesium sulfate is the drug of choice for the treatment of pregnancy-induced hypertension. The blood magnesium concentration should be monitored. Precautions for using magnesium sulfate:

(1) Pay attention to urine volume ≥ 25 ml/hour, knee reflex and breathing.

(2) Use respiratory resistance drugs with caution.

(3) Magnesium sulfate should be used with caution when accompanied by cardiomyopathy.

(4) Intravenous drip is better than push injection.

(5) Pay attention to the relationship between body weight, dosage and flow velocity.

3. Expand blood volume

The use of volume expanders is generally not recommended and is only used for severe hypoproteinemia and anemia. Albumin, plasma and whole blood can be used.

4. Blood pressure reduction

(1) Hydralazine can block α-receptors, causing peripheral vasodilation and lowering blood pressure. The advantage is that it increases cardiac output and renal and cerebral blood flow. The adverse reactions include increased heart rate, facial flushing, accompanied by nausea, palpitations and other discomforts.

(2) Salicylic acid amino derivatives of benzyl salicylate have competitive antagonistic effects on α and β adrenergic receptors. The advantages are good antihypertensive effect, reduced vascular resistance, increased renal blood flow without reducing placental blood flow, and the effects of promoting fetal maturation, reducing platelet consumption and increasing prostacyclin levels.

The above are some characteristics of hypertension during pregnancy. If women suffer from such a disease, they must not be anxious. They should go to the hospital for examination in time. Don’t let momentary carelessness affect your own health and delay the health of your child. Also, don't use medication blindly, as it can easily be harmful to your fetus.