Pregnancy Induced Hypertension (PIH)
Formally known as Pre-eclampsia and Eclampsia
used with permission
Strange how pregnancy is viewed by everyone who has never been a mom to be. It is seen as a happy and joyous time, which it is, but that great time is full of surprises.
Cravings for all the weirdest foods that you normally wouldn't touch with a 10 foot barge pole, throwing up at the smell of your morning coffee which you've had everyday since you were 13, hormones going haywire like you wouldn't believe and finally being so tired that you're up for 10 minutes to run to the bathroom again to find that all you want to do is go right back to bed. As your due date gets closer you feel like a beached whale and your husband, in his wonderful father-to-be mode says that you look "CUTE"!
Most women go through pregnancy and childbirth with a few minor irritations, a few more pounds but without any further complications.
On the Other Hand
One of the problems that occur in 2.6% of pregnancies is Pregnancy Induced Hypertension (PIH). It usually occurs after week 20 and can develop until 1 week postpartum. The cause is not understood yet, but it is probably related to hormone and fluid level changes during pregnancy.
PIH is characterized by a blood pressure over 140/90 or 30 over one's normal reading. So if normally your at 100/65 a blood pressure of 130/95 would be a sign of Pre-eclampsia. Other determining factors are the presence of protein in your urine, weight gain above normal (normal is a gain of 25-35lbs) without an increase in caloric intake, generalized swelling of feet, ankles, hands, and fingers, right upper abdomen or epigastric pain (severe/sudden heartburn like pain). Your doctor will be checking for these signs every time you visit the office. Towards the end of pregnancy they are checked every week, as the symptoms may appear suddenly.
In mild cases of PIH, the woman is ordered to stay in bed and eat an unrestricted balanced diet. Drugs are not usually ordered.
In moderate cases of PIH that are not responding to the above minimal treatment, the woman will be hospitalized for closed monitoring of blood pressure and fluid retention. Other signs that maybe noticed at this point are headaches and/or visual disturbances. These need to be reported right away as they mean that the blood pressure is rising to dangerous levels. If the situation remains unchecked it could lead to seizures, coma and then death. Eclampsia is extremely rare, it only occurs in about 1/200 cases of pre-eclampsia.
Seizures is the defining line between pre-eclampsia and eclampsia. Seizures can happen before, during, or after birth. The only cure is delivery of the baby. Birth may be induced or by cesaerean section. After delivery, mom's blood pressure can be treated with medications. It may take up to 2 weeks to return to normal. Breastfeeding should still be possible.
High blood pressure puts a lot of stress on the kidneys. If protein is found in the urine the doctor will keep monitoring the urine as this is a good way to evaluate the functioning of the renal system. Another system that could be affected by PIH is the cardio-vascular system. If fluid levels are too high because the kidneys are not working properly there is swelling in hands and feet, but the heart also has to pump harder. If there is still too much fluid, the excess flows back into the lungs, causing congestion in the airways, making breathing difficult.
Hypertension can also cause the placenta to separate from the uterine wall (Abruptio Placentae) causing bleeding and denying the baby of much needed oxygen and nutrients. This is a medical emergency. The bleeding could be internal, meaning that the woman would not see any blood, or external where she would. In case of any bleeding, a pregnant woman should be seen by a doctor immediately. If the pregnant woman only 'feels' that there is something wrong, she should trust her instincts. If a health care professional does not give you the answers you understand or need, then find another who will. Your life and the life of your baby may be at risk. If something feels odd, unusual, or wrong seek attention immediately. TRUST YOUR INSTINCTS. God gave them to you for a reason!
This article was written so that you may understand that if you are pregnant and feel something is not right then you are to talk to your doctor. Many people have not heard about Pregnancy Induced Hypertension and wait too long, dismissing the signs as "just another one of those things." This could lead to tragedy.
Most pregnancies are normal and all the doctor's visits are a safety net to spot irregularities before they become a threat. It is imperative that you keep all of your scheduled appointments for your safety and the well-being of your child.
Some useful links for more information:
The Merck Manual is the well-known 'textbook' of medical terms and definitions.
A rather technical but very complete description and explanation of PIH
Read about other women's experiences with ecclampsia .