S.0 MIKAYE: Hypertension in Pregnancy From Diagnosis to Management
S.0 MIKAYE, Medical Doctor at MSK, shared a post on LinkedIn:
“Hypertension in Pregnancy
Definition: BP higher 140, 90 mmHg during pregnancy. Severe hypertension is higher 160 110 mmHg.
Main types
1. Chronic hypertension, present before pregnancy or diagnosed before 20 weeks.
2. Gestational hypertension, develops after 20 weeks without proteinuria or organ dysfunction.
3. Pre eclampsia, hypertension after 20 weeks with proteinuria and or maternal organ dysfunction.
4. Eclampsia pre eclampsia complicated by seizures.
5. Superimposed pre eclampsia pre eclampsia developing in a woman with chronic hypertension.
Common symptoms of pre eclampsia
- Severe headache
- Blurred vision or visual disturbances
- Epigastric or right upper quadrant pain
- Shortness of breath
- Reduced urine output
- Sudden swelling or weight gain
Assessment
- Repeated BP measurements
- Urine protein assessment
- FBC platelets
- Renal and liver function tests
- Fetal growth and wellbeing assessment
Management
- Monitor mother and fetus closely.
- Pregnancy compatible antihypertensives include labetalol, nifedipine and methyldopa.
- Severe hypertension requires urgent treatment.
- Magnesium sulfate is used for seizure prevention or treatment in severe pre eclampsia eclampsia.
- Definitive treatment is delivery, with timing depending on maternal and fetal condition.
Major complications
Mother: eclampsia, stroke, HELLP syndrome, renal failure, pulmonary oedema, placental abruption.
Baby: fetal growth restriction, prematurity, fetal hypoxia and stillbirth.
BP higher 140,90 after 20 weeks plus proteinuria or organ dysfunction lead to pre eclampsia.”
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