Pregnancy Induced Hypertension, Preeclampsia, & Eclampsia
Tessa K. Larsen
Mercy College of Health Sciences
Pregnancy induced hypertension or Gestational hypertension, is a condition of high blood pressure unique to human pregnancy. Hypertension during pregnancy affects about 5-10% of all pregnant women worldwide (Baker, 2004, P. 16). Hypertension can prevent the placenta from getting enough blood. If the placenta does not receive enough blood, the baby gets insufficient amounts of oxygen and nutrients. This can result in low birth weight and other severe complications (Simkin, Walley, Keppler, 2008, P. 75). Pregnancy induced hypertension (PIH) can lead to a serious ...view middle of the document...
It is considered severe when a systolic blood pressure reads greater then 160 mmHg and or diastolic blood pressure 110 mmHg, on two readings, taken at least 6 hours apart. This PIH can also be defined even in a normal pregnancy if the woman is 20 weeks pregnant but has no proteinuria (less than .3g over 24 hours) (Baker, 2004, P.11). When proteinuria is present, the hypertensive disorder is then classified as gestational hypertension with Preeclampsia. (The etymology of preeclampsia, pre- means before, ek- means out and lamp- to flash which means “before flashing out.”) “Preeclampsia is the second leading cause of maternal death worldwide. It is second to only postpartum hemorrhages “(Baker, 2004, P.17). “It accounts for approximately 790 maternal deaths per 100,000 live births.” (Baker, 2004, P.16)
Three major symptoms of preeclampsia are increased blood pressure, protein in your urine and edema (Chesley, 1974). If blood pressure is high it can affect how well your kidneys filter your blood. Proteins that should stay in your blood leak into your urine, causing proteinuria. Small amounts of proteinuria is common in pregnancy since kidneys have to work harder during pregnancy. If this number is high it can indicate preeclampsia.
Edema is sudden fluid retention and swelling from damage to the vessel walls. Whether it is damage from high blood pressure or pelvic pressure on vessels due to pregnancy. This can be present as puffiness around the eyes, face, hands, ankles or feet. This can cause joint pain, stiffness and loss of mobility. Pulmonary edema can also occur, causing shortness of breath or chest pain (Baker, 2004, P. 20).
Vasospasm is a condition that can occur as preeclampsia progresses. Long periods of high blood pressure put blood vessels under a lot of stress, weakening vessel walls and increasing resistance to blood flow. If vasospasm is worsens this will present itself physically as hyperreflexia. Clonus or hyperreflexia is over reactive reflexes due to damage to the central nervous system. This is a common neurological symptom when dealing with preeclampsia-eclampsia (Baker, 2004, P. 22).
HELLP syndrome is one of the most severe variants that occur in 10% of preeclampsia patients (Chesley, 1978). HELLP is an acronym for hemolysis, elevated liver enzymes, and low platelets, which is a syndrome of the red blood cells and liver complications (simkin et al, 2008). Not all women have all of these findings. It is important to understand that this syndrome may develop at anytime whether the women have mild or severe preeclampsia. Patients may present with the syndrome either before the delivery or shortly thereafter. Usually patients present before 40 weeks of gestation complaining of epigastric pain or pain in the right upper quadrant of the abdomen. This is due the stretching of the Glisson’s capsule of the liver due to hepatic swelling or bleeding. Other symptoms of the syndrome are headache, vision problems,...