Hypertensive disorders of pregnancy, previously know as Pregnancy induced hypertension (PIH), are high blood pressure disorders of pregnancy. It has long been one of the major problems for mothers in pregnancy, along with infection and postpartum hemorrhage. Preeclampsia affects 5-8% of all pregnancies but 10-20% of mothers will have a hypertensive disorder during pregnancy.
There are four different levels of hypertensive disorders in pregnancy:
- Chronic Hypertension (Discovered prior to 20 weeks gestation.)
- Gestational Hypertension
- Preeclampsia/Eclampsia superimposed on chronic hypertension
PIH can be detected early during regular prenatal visits, which is one of the reasons they are so very important. If you have PIH and it is untreated you may wind up with a preterm baby, a stillborn baby or a baby who has growth restriction (IUGR), not to mention the effects on your health.
There are still different opinions on the causes of PIH. There are speculations of placental involvement, underlying disease, hormonal involvement etc.
If you experience any of the following warning signs, report them to your practitioner:
- Rapid weight gain, 4 - 5 lbs in a single week
- A rise in your blood pressure
- Protein in your urine
- Severe headaches
- Blurry vision
- Seeing spots in your eyes
- Severe pain over your stomach, under your ribs
- Decrease in the amount of urine
Not all of these symptoms or signs may be detected by an individual. This is one of the reasons that it is so important that you keep your regular prenatal appointments is to screen all women for the above symptoms as well as other signs of PIH. If you must miss an appointment be sure to reschedule it right away.
There are treatment options for those women suffering from chronic hypertension or gestational hypertension, including hypertensive medications. Some practitioners recommend strategies that are dietary, while others involve exercise and rest. Recently it has been shown that aspirin doesn't help in the treatment for women in a low risk group but can be helpful for a select high risk group. If you have preeclampsia, the only cure is delivering the baby. Talk to your practitioner about which options are best for you because this is critical.
The important thing to remember is that PIH is a very serious illness. You must be followed closely by your medical professional to help prevent prematurity and death of your baby and other severe complications in the most severe cases.
Now it is also known that even slight rises in the blood pressure during pregnancy can have a lasting effect. Women who have PIH or more severe forms are at greater risk for coronary artery disease later in life.
Source: Sabour A et al "High Blood Pressure in Pregnancy and Coronary Calcification" Hypertension 2007; 2: online