A Special Look at Hypertension and Pregnancy Part II

In the first part of this topic you learned about what Pre-eclampsia is, and the risk factors that your mom, sister, tantie, wife, niece or cousin may have, that predisposes her to developing this ailment. You also learnt about signs and symptoms of this sickness, and the importance of encouraging your pregnant loved one to go for her antenatal checkups.

For a review of Part I click here.

In Part II, we'll have a look at the complications of pre-eclampsia, for both mother and baby, as well as treatment, and prevention.


courtesy www.clipartbest.com


First let's have a look at complications for the Moms-to-be...

COMPLICATIONS

Maternal Complications


SEIZURES

For women suffering from preeclampsia, any type of convulsive activity or fit that she suffers after 20 weeks gestation or immediately after giving birth is known by the name of Eclampsia.
When suffering an eclamptic seizure, the mom-to-be may suffer involuntary repetitive, jerky movements of the arms and legs, or may have facial twitching.


STROKE

High blood pressure can cause a brain injury, due to an interruption of blood supply to the brain.


PULMONARY OEDEMA

In this complication fluid builds up inside of the lungs, preventing them from receiving oxygen and functioning properly.


KIDNEY FAILURE

Hypertension can cause more pressure on the kidneys of pregnant women, and the damage it causes allows to kidney to be unable to filter the toxins out of the body, which causes an increase of toxicity in the blood and body.

CLOTTING DISORDERS

This complication can cause an increase in blood clot formation within the mother´s body, or can cause excessive bleeding because the blood clotting system begins to fail.


HELLP SYNDROME


This is a complication that is characterized by:
1) Destruction of the mother's red blood cells, known by the term hemolysis.
2) An increase in the amount of certain liver proteins known as enzymes.
3)  A decrease in one of the blood elements responsible for clotting known as platelets

To read about more maternal complications, click here ....





courtesy www.etsy.com

Fetal Complications

Fetal complications stem from a decrease in blood flow to the uterus, the placenta is thus deprived of oxygen and nutrients essential to the baby's growth and development, as a result the baby can suffer:

  • Intrauterine Growth Restriction in which the baby does not grow as it should according to its age in weeks. As a result after birth the baby may be smaller than it should be.
  • Lack of oxygen while inside the uterus also known as Intrauterine asphyxia.
  • Prematurity, or being  born before it is full term, that is, 37 weeks.
  • Respiratory Problems after being born (Neonatal Asphyxia).
  • Intrauterine Fetal Death.

courtesy www.cen.acs.org


TREATMENT

The optimum treatment of pre-eclampsia is induction of labour. However, the manner in which this is done is very much dependent on the severity of the pre-eclaampsia, the number of weeks the pregnancy currently has progressed to, and how the baby is doing. 

Possible treatment include used of  blood pressure medication such as, methyldopa, nifedipine or labetalol
Methyldopa or Aldomet is the treatment of choice in pregnancy and functions by relaxing blood vessels, reducing the pressure of the blood inside them, ensuring that the blood can circulate more efficiently around the body.

To understand how Nifedipine or Adalat works, read about Calcium Channel Blockers in the last section of the blog post from March:  So You Already Suffer from High Blood Pressure Pt I...

To understand how Labetalol functions, read about Beta-Adrenoceptor Antagonists in the last section of the blog post from April: So You Already Suffer from High Blood Pressure Pt II...


courtesy heart.org

PREVENTION

How can pre-eclampsia be prevented?  Can it be? 
It cannot be totally prevented. However, the risk or suffering from it during pregnancy can be reduced through the following ways:

1) Be aware of the risk factors that are present in your life.
2) Know the symptoms to look out for.

To read about risk factors and symptoms of pre-eclampsia read the first part of the blog post, A Special Look at Hypertension and Pregnancy Part I

3) Make certain that all antenatal appointments are attended. 



Never underestimate the value of the blood pressure checks, the blood and urine investigations done,the weight checks, as well as the constant focus on the growth and development of your baby
The more antenatal clinic appointments attended the quicker any risk of developing pre-eclampsia will be detected. In Wadadli antenatal care is free, and thus ought to be taken advantage of. 
It is a privilege that many women on this planet do not have.

4) For women who have high risk of suffering from pre-eclampsia, low dose aspirin or calcium                 supplementation may be prescribed, to lower its appearance as well as its complications.


Pre-eclampsia is one variant of different categories of high-blood pressure related illnesses during pregnancy, to read more about the other variations click here.

You can also read more here.



With this we've ended not only our look at hypertension in pregnancy but our discussion about hypertension in general as a sickness that affects our Wadadlian population.

High blood pressure ought not to be played with whether pregnant or not, whether old or whether young. It is dark portal that leads to a pathway of other diseases and complications that will without doubt affect your daily life. 

Hopefully through these posts you are now able to identify any risk factors present in your life or that of your loved ones, and most importantly be able to share you knowledge with someone who you know may be at risk. 

Rememba wa dem say, "Prevenshan betta dan cyur"




#Wadadlianstrong

Blessings to you and yours, 





© June 2014


A Special look at Hypertension and Pregnancy Part I


Good-day everyone! 
It's been a while but we're back sharing information, and helping you learn more about conditions that affect our Wadadlian Community. 
To continue the series we have embarked upon about the Cardiovascular System and Hypertension on the Wadadlian Health Blog, we'd like to share a bit about Hypertension related to pregnancy. 


courtesy heart.org


Pregnancy is a beautiful period in a woman’s life where she is the nurturing element that propels new life into the world, but too often we see that at this time, where ideally she should be eating wholesome foods, resting adequately and allowing for the healthy development of her baby, she can be plagued with many ills which can further complicate her physiological condition. 

Today our focus will be on Pre-eclampsia also known as Toxemia, one of the most frequently seen complications during pregnancy. This variation of the ‘silent killer” can be asymptomatic in its early stages in pregnancy and only provoke symptoms when it is very advanced. 

In Part I we'll be touching on its definition, risk factors, as well signs and symptoms to look out for.

Pre-eclampsia can be defined as the elevation of blood pressure to at least 140/90 mmHg that is induced during pregnancy usually after 20 weeks of gestation, and often is associated with protein being found in the urine. The condition resolves 6 weeks after the baby is born.




courtesy American Pregnancy Association

The exact cause of pre-eclampsia is not verified but research suggests it may be a problem with the blood vessels in the placenta, and the way it is attached to the womb (the placenta or  afterbirth, is the structure that lies between your baby and your  womb.)

Bear in mind, all pregnant women can develop pre-eclampsia however there are some who may be more likely to have it during pregnancy due to certain risk factors in their life.


                                           
                                                           courtesy blackradionetwork.com

Risk Factors of Pre-eclampsia:

1. History of previous pre-eclampsia.  A personal or family history (mother or sister) of pre- eclampsia increases your risk of developing the condition.

2. First pregnancy. The risk of developing pre-eclampsia is highest during your first pregnancy.             

3. New paternity. Each pregnancy with a new partner increases the risk of pre-eclampsia.

4. Age. The risk of pre-eclampsia is higher for pregnant women younger than 20 and older than 40 years of age. 

5. Obesity. The risk of pre-eclampsia is higher if you're obese.

6. Multiple pregnancy.  Pre-eclampsia is more common in women who are carrying twins, triplets or other multiples.          

7. Prolonged interval between pregnancies. Specifically of 10 years or more seems to increase the risk of suffering from the condition.

8. Diabetes and gestational diabetes.  Women who develop gestational diabetes or already suffered from diabetes prior to becoming pregnant have a higher risk of developing pre-eclampsia as the pregnancy progresses.

9. History of certain pre-existing conditions.  Having certain conditions before you become pregnant- such as chronic high blood pressure, migraine headaches, urinary tract infection, vitamin D deficiency, diabetes, kidney disease, rheumatoid arthritis or lupus, amongst others increases the risk of pre-eclampsia.

10. Ethnicity. Pre-eclampsia is found to be more common amongst the black race. Click here to read more.             


                                                    courtesy womenshealthency.com


Bear in mind it is possible that pre-eclampsia may be asymptomatic, with only high levels of blood pressure and proteins found in urine aiding in its diagnosis, this is why it is SO VERY IMPORTANT  to have regular checks of your blood pressure while pregnant. 

If you are unsure about the values of blood pressure readings and what they mean, no worries, you can read LAWD MA PRESSHA PART II from an earlier post in February.

Please note that in pregnancy values between:
                                               140/90 to 149/99 mmHg = mild hypertension 
                                               150/100 to 159/109 mmHg = moderate hypertension
                                               160/ 110 mmHg and above = severe hypertension


                                                                    

courtesy American Heart Association


Signs and Symptoms of Pre-eclampsia:

Apart from high levels blood pressure (hypertension), and the kidneys leaking proteins into the urine, pregnant women may experience:

Dizziness 
Blurry vision or seeing marks or spots in your vision
Photophobia or the eyes being irritated in the presence of light 
Headaches that are constant, or repetitive
Swelling of the feet, hand, and face (now this happens normally during pregnancy, but if this suddenly becomes worse it must be taken into consideration)
Sudden weight gain
Decrease in urination
Nausea and vomiting, (that is different from morning sickness in the early stages of pregnancy)
Decrease in the baby's movements
Belly pain, most frequently on the right side below the ribs
Shortness of breath

It is important to be aware of these symptoms and signs not only during pregnancy but after giving birth as pre-eclampsia extends for 6 weeks after the baby is born.


In Antigua and Barbuda full antenatal care is provided in our district clinics, this a privilege to be taken advantage of. It cannot be expressed how IMPORTANT it is to receive regular checkups during pregnancywhether it is the first time being pregnant or the fifth. Pre-eclampsia is a form of hypertension that is harmful to both mother and child when undiagnosed. 

Feeling well, by no means indicates that you actually are, and without proper checkups and antenatal care, it is possible that both the mother and unborn child will suffer in the deadly silence of hypertension.

If you have a loved one who is currently pregnant, encourage them to get their checkups done at the clinic, blood pressure screening will always be done.

In Part II we'll be addressing the complications of Pre-eclampsia as well as the treatment, and most importantly the aim of this blog PREVENTION.

Keep your family, both future and present, #wadadlianstrong.



Blessings to you and yours,

 
© June 2014