Pregnancy induced hypertension is a complication that affects around 6-8% of women during their pregnancy. While this can become quite serious, especially if preeclampsia is developed, it can easily be ignored if you do not do regular testing.
Many of the symptoms that are associated with the disease are common, pregnancy-related pains, which would go unnoticed to first-time mothers – who are the most likely demographic to be affected by this complication.
Table of Contents
- What Is Pregnancy Induced Hypertension
- Pregnancy Induced Hypertension Treatment
- What Is the Gravest Form of Pregnancy Induced Hypertension?
- Pregnancy Induced Hypertension Symptoms
- Pregnancy Induced Hypertension Complications
- Causes of Pregnancy Induced Hypertension
- Who Is at Risk of Pregnancy Induced Hypertension?
- Pregnancy Induced Hypertension VS. Preeclampsia
- Nursing Diagnosis for Pregnancy Induced Hypertension
- Ask Help for Doctor about Pregnancy Induced Hypertension
Pregnancy Induced Hypertension (PIH) or Gestational Hypertension is a common pregnancy complication. Pregnancy Induced Hypertension is when you have an abnormal level of protein in your urine and develop a high blood pressure during pregnancy.
There are essentially three types of Pregnancy Induced Hypertension, which varies in severity. The most severe is preeclampsia, which can be extremely dangerous for you and your baby.
Pregnancy Induced Hypertension Treatment
Treatment for Pregnancy Induced Hypertension depends on so many factors, such as the severity of your case, medical history, timing in your pregnancy, overall health and, of course, what works for you as an individual.
This makes it difficult to find one solution to Pregnancy Induced Hypertension. However, there are some forms of treatment that work for many – either singularly or used together.
Similar to most complications or injuries, bed rest can be extremely beneficial for women who have Pregnancy Induced Hypertension. While there is not exactly proof that practicing bed rest is effective, many women find it to be quite helpful.
As a result, it remains a popular treatment for Pregnancy Induced Hypertension. While bed rest is not exactly a definitive treatment, it should be used alongside with other treatments to help you rid yourself of the painful symptoms.
It is recommended that you specifically lie on your left side in a somewhat peaceful and quiet environment, either at home or in the hospital – depending on your doctor’s recommendation.
Some have found that starting short term drug therapy has helped lessen symptoms or get rid of their Pregnancy Induced Hypertension altogether. Drug therapy is somewhat controversial though, as it can carry some risks for both you and your child.
However, in short term it is less risky. Options for short term drug therapy are usually Labetalol, Hydralazine, Sustained-release Nifedipine and Immediate-release Nicardipine.
Long Term Drug Therapy
Sometimes, bed rest and short term drug therapy are not enough to alleviate the pains associated with Pregnancy Induced Hypertension. As a result, this leaves long term drug therapy as a treatment.
Long term drug therapies generally last multiple weeks or months and the drug choices are essentially the same as short term drug therapy, with the inclusion of Methyldopa and Long-acting calcium channel blockers.
As mentioned, this is controversial, as using any sort of drugs during a pregnancy carries certain risks for you and your baby.
To ensure that the Pregnancy Induced Hypertension is being controlled, it is crucial to do continued testing throughout the pregnancy.
These tests mainly monitor the fetus with a variety of constant tests, such as fetal movement counting, nonstress testing, biophysical profile and Doppler flow studies.
Also, this includes the continued testing of the mother’s urine and blood to watch out for irregular protein levels and other signs that could lead to the worsening of the complications.
Ideally, these treatments should help alleviate the symptoms of PIH, or hopefully eliminate the complication and pains associated with it entirely.
However, this is not always the case. If the Pregnancy Induced Hypertension worsens to a critical point, often, the only solution to ensure the mother’s safety is to remove the placenta and baby – no matter what point she is at in her pregnancy.
What Is the Gravest Form of Pregnancy Induced Hypertension?
The gravest form of Pregnancy Induced Hypertension is Hemolysis, Elevated Liver Enzymes and Low Platelets Syndrome (HELLP syndrome.) HELLP syndrome is a variant of preeclampsia and can be extremely dangerous and even fatal for the mother and her child.
If the complication occurs later in pregnancy, it tends to be better for the pregnancy. This is because the only treatment for HELLP syndrome is immediate delivery of the placenta and baby.
Many times, cases of Hemolysis, Elevated Liver Enzymes and Low Platelets Syndrome are misdiagnosed and often viewed as only a severe preeclampsia, rather than HELLP syndrome.
Around 10% of women who have preeclampsia actually develop HELLP syndrome, but these are almost never diagnosed. This is because each case is so unique that the symptoms are so specific to the person experiencing them.
However, to ensure the safety of the mother and child, diagnosing the HELLP syndrome early on is necessary.
Pregnancy Induced Hypertension Symptoms
Pregnancy Induced Hypertension is a complication that affects every single woman in a very different way. For this reason, it becomes extremely difficult to diagnose, as some symptoms seem like they may even be normal for a pregnancy.
This makes it difficult for first-time pregnancies, as these mothers do not know what is normal for their bodies. However, Pregnancy Induced Hypertension unfortunately affects more first-time mothers than those who have had previous children.
The initial signs of it are almost impossible to notice. Generally, PIH can be recognized in hasty weight gain and extreme fluid retention. This leads to swelling, specifically in the face and ankles. However, this is normal for pregnancies, so it is difficult to catch.
Sme other symptoms that may seem normal for a pregnancy but can also be a sign of Pregnancy Induced Hypertension are vomiting and nausea, fatigue, shortness of breath and abdominal pain.
There are luckily symptoms that are far easier to notice though, such as blurred vision and headaches, inability to produce very much urine or tolerate bright light. These are all symptoms that you can pick up on yourself.
However, your doctor, who should be watching out for possible signs of PIH, has other symptoms they can notice. Doctors, through urine tests, can pick up on protein level abnormalities in the urine, which is a symptom specific to Pregnancy Induced Hypertension.
Pregnancy Induced Hypertension Complications
As mentioned previously, complications that may occur during Pregnancy Induced Hypertension, or PIH, include weight gain, headaches, abdominal pain, disturbed vision, sensitivity to light and brisk reflexes.
If PIH progresses to eclampsia and then preeclampsia, the risks become much more severe. The most severe, of course, being death. There are also risks to the child, which include a slowing of growth, premature delivery, or death.
If you are at risk of these things during your pregnancy, your doctor will most likely recommend having your baby early.
On top of that, there are chances that you will continue to have high blood pressure in the future even after birth and even after your blood pressure initially returns to normal.
Causes of Pregnancy Induced Hypertension
The most simple and common answer as to what causes PIH is that the causes are unknown. A small percentage of pregnant women simply develop it and it usually occurs during first pregnancies, as mentioned.
Age could be a factor, but even that’s a guess because the age range of those who develop PIH is so wide. For example, if you’re younger than 25, you can develop it as well as if you’re older than 35.
The peak age of pregnancy without PIH seems to be mid-20s to early 30s, but that isn’t a guaranteed safety net.
If you’ve suffered with chronic hypertension before or have kidney disease or diabetes, you are at a higher risk of experiencing Pregnancy Induced Hypertension. Pre-existing high blood pressure can also create a higher risk.
You are also at risk if you are pregnant with more than one baby, whether it is twins, triplets, or quadruplets. If you are nurturing multiple fetuses, your risk for developing Pregnancy Induced Hypertension rises.
Who Is at Risk of Pregnancy Induced Hypertension?
Those who are more at risk of Pregnancy Induced Hypertension, as stated before, are first-time mothers. However, they’re not the only ones.
Others who are also at risk include:
- Women related to someone who had PIH (i.e. PIH can be a genetic condition and runs in the family)
- Women who are under the age of 20
- Women who have high blood pressure
Overweight or obese women can also fall into the category of those at risk of developing PIH. This is why doctors always recommend that you watch your weight and not indulge every craving before or during your pregnancy.
Pregnancy Induced Hypertension VS. Preeclampsia
While there are similar symptoms and risks between Pregnancy Induced Hypertension and Preeclampsia, research shows that the two medical complications are two very different and separate things.
PIH sometimes can progress to preeclampsia, but that is not always the case. If a woman has had PIH in a prior pregnancy, there’s a chance she will develop PIH again.
On the other hand, if a woman has had preeclampsia in a prior pregnancy, there’s less of a chance that she will develop preeclampsia again. More risks are associated with preeclampsia, making it the more dangerous complication.
Women who suffer from PIH during pregnancy have less of a chance of that condition impacting their pregnancy outcome. In fact, women with PIH usually have healthy babies, just as a woman with an uncomplicated pregnancy would.
However, women who suffer from preeclampsia more often find themselves suffering from the risks listed above: growth restriction, placental abruption, low birth weight, premature births and even stillbirths or infant deaths.
The percentage of women with PIH who will progress to preeclampsia can range from anywhere between 10% to 50%. However, the two complications are very different and one will not always lead into the other.
Those at high risk of progressing to preeclampsia should know what signs and symptoms to look for. However, those without high risk of progressing should know that they are at low risk of having any birthing complications and everything should proceed as normal.
Since Pregnancy Induced Hypertension is a common risk in women, nurses and doctors know what to look for and what tests to perform to see where each patient is in terms of their pregnancy health.
With that in mind, diagnosis tests can be pretty straightforward. Below is a list of a few things that they will check and look out for in order to diagnose you.
One of the most common tell-tale signs of whether someone has PIH is if their blood pressure is higher than it should be. High blood pressure can develop either early on in a pregnancy, or later in a pregnancy.
If high blood pressure is a later development that you haven’t experienced before being pregnant, you are at higher risk of developing preeclampsia.
As mentioned, if protein is found in urine during a urine test, this is a sign of PIH. Checking urine is a common procedure in determining whether a person has PIH or not.
Other symptoms that nurses will look at to diagnose you with PIH are:
- History of chronic hypertension
- Decreased pulse
- Spontaneous bruising
- Weight gain
- Decreased responsiveness
Ask Help for Doctor about Pregnancy Induced Hypertension
It is not yet known why Pregnancy Induced Hypertension occurs in most patients. However, there are common factors like age and prior health histories that can point you in the direction to take if you want to reduce or prevent your risks of having these complications.
The risks associated with Pregnancy Induced Hypertension and the things it can lead to like preeclampsia make this a complication that should be taken seriously – for both the health of the mother and child.
Both parent and child can risk death if PIH progresses to preeclampsia or eclampsia, so every caution must be taken.
If you think you are experiencing symptoms that point to the development of PIH, talk to your doctor about it to make sure you aren’t at risk of the more serious complications.
Your doctor will know what to look for and put you on the right path to making sure your upcoming pregnancy and delivery are as safe as possible.