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Risk Factors:

1.) Primigravida
2.) Primipaternity
3.) Maternal age < 18 or > 35
4.) Family history of Pregnancy-Induced Hypertension
5.) Large uterine mass; multiple gestation, fetal hydrops (Rh sensitization),
diabetes mellitus
6.) African-American heritage, history of chronic renal or vascular disease
7.) Molar pregnancy

Signs and Symptoms:


1.) Increased blood pressure
2.) Protein in the urine
3.) Edema (swelling)
4.) Sudden weight gain
5.) Visual changes such as blurred or double vision
6.) Nausea, vomiting
7.) Right-sided upper abdominal pain or pain around the stomach
8.) Urinating small amounts
9.) Changes in liver or kidney function tests

Treatment for Pregnancy-Induced Hypertension:


The goal of treatment is to prevent the condition from becoming worse and to
prevent it from causing other complications. Treatment for pregnancy-induced
hypertension (PIH) may include:
• bed rest (either at home or in the hospital may be recommended)
• hospitalization (as specialized personnel and equipment may be necessary)
• magnesium sulfate (or other antihypertensive medications for PIH)
• fetal monitoring (to check the health of the fetus when the mother has PIH)
may include:
o fetal movement counting – keeping track of fetal kicks and
movements. A change in the number or frequency may mean the fetus
is under stress.
o nonstress testing – a test that measures the fetal heart rate in
response to the fetus’ movements
o biophysical profile – a test that combines nonstress test with
ultrasound to observe the fetus.
o Doppler flow studies – type of ultrasound that uses sound waves to
measure the flow of blood through a blood vessel.
• continued laboratory testing of urine and blood (for changes that may signal
worsening of PIH)
• medications, called corticosteroids, that may help mature the lungs of the
fetus (lung immaturity is a major problem of premature babies)
• delivery of the baby (if treatments do not control PIH or if the fetus or mother
is in danger). Cesarean delivery may be recommended, in some cases.
Pathophysiology of Pregnancy-Induced Hypertension

PREGNANCY-INDUCED
HYPERTENSION (PIH)

Vasospa
sm

blood pressure organ vascular


circulating perfusion damage
volume
extravascular
fluid
placenta cerebru retin kidne live vascular
m al ys r and
hematolo
gic
IUGR edema oliguria periportal system
edema
fetal ischemi visual Na+ hemorrhag microangiopath
O2 a disturban retention ic necrosis ic hemolysis
ce proteinuria
platelet
adherence
headach
fibrin deposition
e retinal
detachme plasma
abrupti seizur nt proble AST
o e ms platelets
coma pulmona ALT
ry periphera
edema l edema subcapsul
CHF ar
fetal hematom HELLP
distres intracrani renal a syndrom
s al tubular e
hemorrha necrosis
ge
acute liver DIC
renal ruptur
fetal matern failure e
deat al
h death

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