Normal people usually have normal blood pressure (BP). But, actually most people have hypertension nowadays. T_T However, pregnancy can also induce hypertension - due to hormones, the placenta (uri) and the struggle of pregnancy itself. Hypertension in pregnancy is not something to take for granted, in fact it is in the top 5 disorders in pregnancy that can harm mothers (lead to death).
For people who have family's background for hypertension, we need to be extra careful on our lifestyle and diet.
1. Hypertension - different terms in pregnancy.
There are quite a number terms and definitions I need to understand and remember in order to get the proper diagnosis and plans for specific patients.
Hypertension in general can reduce blood flow to many organs like:
I am still learning and observing this situation.
But, from my knowledge, once a pregnant woman is diagnosed with hypertension or have BP ≥ 140/90 in any check-ups in Klinik Kesihatan and written in their pink books, she need to get her BP measured every other day (EOD). This means, day 1 - day 3 - day 5 and continuously until her next check up or even until delivery of baby. Even after labor, her BP need to be monitored to make sure it is in a safe range.
Believe me, in unfortunate events, some patients can skip all these and go direct to seizure T_____T
Pregnant women who are / have:
These five alphabets are scary to me. It actually means - To Rule Out Impending Eclampsia
The havoc to manage a fitting pregnant woman is not a joke. At least few people need to take part in this especially to:
And if you are diagnosed with hypertension in pregnancy, please and please make sure you follow what your doctors have told you. If you need to take medications, please don't skip. If you need to get your BP measured every other day, please do so even though it can be a hassle.
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"Seizure in pregnancy is eclampsia until proven otherwise."
2. Why hypertension can be harmful in pregnancy?Well, hypertension is dangerous no matter someone is pregnant or not. In this post, I would love to share why and how hypertension in pregnancy is not an easy matter.
Hypertension in general can reduce blood flow to many organs like:
- brain (can lead to coma etc),
- heart (heart failure / attack etc),
- kidney (renal failure etc),
- eyes (blurring of vision etc),
- etc
So, can we imagine what can happen to the baby if the mother herself is not in good condition?
In O&G, mothers always come first to be rescued, only then the baby.
In O&G, mothers always come first to be rescued, only then the baby.
Effects - premature birth, stillbirth, complications to babies afterwards (learning disability, seizure etc)
3. How will be the routine for pregnant women with hypertension?
I am still learning and observing this situation.
But, from my knowledge, once a pregnant woman is diagnosed with hypertension or have BP ≥ 140/90 in any check-ups in Klinik Kesihatan and written in their pink books, she need to get her BP measured every other day (EOD). This means, day 1 - day 3 - day 5 and continuously until her next check up or even until delivery of baby. Even after labor, her BP need to be monitored to make sure it is in a safe range.
4. What are the signs & symptoms of impending eclampsia?Patients usually complain of headache, dizziness (rasa pinar-pinar), blurring of vision, epigastric pain (pedih ulu hati), nausea (mual), vomiting, edema (kaki bengkak). These are the things need to be watched out every time we meet patients with hypertension.
Believe me, in unfortunate events, some patients can skip all these and go direct to seizure T_____T
5. Who is at risk of pre-eclampsia / eclampsia?
Pregnant women who are / have:
- Previous history of pre-eclampsia
- Other diseases - kidney, diabetes etc
- Multiple pregnancy - twins / triplets etc
- Obesity
- Primigravida (first pregnancy)
- Family history of pre-eclampsia
6. How a hypertensive pregnant woman can be admitted to the hospital?As someone who have been clerking patients coming to EPAU (Early Pregnancy Assessment Unit) or in some place this unit is called PAC (Pregnancy Assessment Center), most pregnant women who came for high BP is diagnosed with 'TRO IE'.
These five alphabets are scary to me. It actually means - To Rule Out Impending Eclampsia
- They have high BP
- 80-90% of them have proteinuria (protein in urine).
- Some of them have signs and symptoms of Impending Eclampsia.
- Some even ended up with seizure.
- Most of them need to have induction of labor (IOL) / emergency C-sec (EMLSCS) as they can't exceed 38weeks! to deliver the baby - delivery is the best way to avoid the worst scenario.
The havoc to manage a fitting pregnant woman is not a joke. At least few people need to take part in this especially to:
- Prepare Magnesium Sulphate bolus and infusion (to fight the seizure),
- To check all vital signs (BP. pulse rate, respiratory rate, temperature)
- To recheck Pre-Eclampsia profile (full blood count, liver function test, renal profile, urine full examination and microscopy examination, coagulation profile)
7. How to avoid these?Hmm.. first, let's pray hard to all pregnant women to have a smooth and uneventful pregnancy. Live a good and healthy lifestyle, control our diet, don't ever skip any antenatal check-ups.
And if you are diagnosed with hypertension in pregnancy, please and please make sure you follow what your doctors have told you. If you need to take medications, please don't skip. If you need to get your BP measured every other day, please do so even though it can be a hassle.
"Seizure in pregnancy is eclampsia until proven otherwise."
M, Perak, Malaysia
180323
