How to deal with Hypertension during pregnancy? - Dr. Kavitha Lakshmi

Classification during headache has been classified under 5 major headings. Chronic hypertension predisposed or no predisposed with preeclampsia, gestational hypertension, ecclampsia, and help’s syndrome. Irrespective of the cause or the type of hypertension in pregnancy, any BP of more than 140 systolic by 90 diastolic has been treated. The cause has been said to be defective implantation that has happened. the predisposing factors to see whether the patient is high risk for developing hypertension during pregnancy would be the age of the patient less than 20 or more than 40 .patient with strong family history of hypertension, patient with chronic disease like chronic kidney disease , superimposed with hypertension or a connective tissue disorder or vasculitis or an APS syndrome or hyperhomocystenemia or heart disease complicating pregnancy has to be looked into these are the patient who are predisposed to developing hypertension during pregnancy , other chronic disease like diabetes or gestational diabetes with complications has to be dealt with. Why do we have to treat hypertension or prevent hypertension from coming into pregnancy. It is because there are other complications, the signs and symptoms which we have to look into in pregnancy are sudden increase in weight gain, generalized swelling predisposing to edema. Other predisposing factors which we have to look into is signs and symptoms in pregnancy, an excessive weight gain or edema in the leg, or generalized edema, positive roll over test or Doppler scan of the uterine artery showing a diastolic raunch or a raised pulsatility index. As we say, prevention is better than cure. So we give low dose aspirin between 75 to 150 mg per day till about the 34th or the 36th week of pregnancy. Heparin is also given in severe cases. Low salt or salt restricted diet has to be taken and relative bed rest has to be advised, the need for treatment is because of the complication that arise associated with hypertension with the mother and the baby. With regards to the mother, there can be organ dysfunction relate of the kidney, heart, liver and the coagulation system and abruption placenta is one of the dreaded complications that can happen. With regards to the baby, intrauterine growth restriction and oligohydramnios has been associated. Both of which might require a premature e delivery and hence the complications associated with prematurity also has to be talked. Treatment options are bed rest, prophylactic therapy to be continued. The 4 main drugs used to control hypertension in pregnancy are Labetolol, hydralazine, alpha methyl dopa, and nifedepine. Other drugs are contraindicated in view of complications to the baby, be in terms of intrauteruine growth restriction and oligohydramnios and the prematurity related risks. So in a nut shell hypertension in pregnancy has to be expected prevented and treated at the right times so that the mother and the baby can be sent home safely.