Nowadays, pregnant women suffering from high blood pressure are often seen during daily rounds in the obstetrics ward. Also, high blood pressure is one of the main problem for women who suffer from medical problems during pregnancy.
After 20 weeks of pregnancy, if the blood pressure of a pregnant woman exceeds 140-90 and protein (albumin) appears in the urine, it should be considered a blood pressure problem. In medical term it is also called Preeclampsia if left untreated it may leads to Eclampsia.
Stages of Preeclampsia or Types of Preeclampsia
Preeclampsia in pregnant women can be divided into three types:
1. high blood pressure but no protein in the urine
2. high blood pressure with protein but no tremors and
3. high blood pressure with protein as well as tremors also.
What causes PreEclampsia or Eeclampsia ?
If the age of the pregnant woman is younger or older during the first pregnancy, if someone in the family or siblings or you have blood pressure in the previous pregnancy, if there is any malfunction in the uterus, if the size of the uterus is large due to some reason (when twins, when the blood group does not match between the couple, due to diabetes), during the pregnancy If there is not enough blood flow, if there is a molar pregnancy that looks like a grape seed without seeing the entire pregnancy, if the male partner is different between births, if there is a history of blood poisoning or kidney problems, women with blood clotting problems are more likely to develop high blood pressure.
Pre Eclampsia Symptoms
If the problem of blood pressure during pregnancy can be detected on time and if the necessary lab tests and advices are followed under the supervision of the doctor, there is no more danger due to high blood pressure. But for that, regular pregnancy tests are required. It is found out whether the blood pressure has increased or not while measuring the blood pressure during frequent pregnancy check-ups. In addition to blood pressure, symptoms such as knee swelling, headache, sleep disturbance, blurred vision, burning in the upper part of the stomach, abnormal weight gain, and small uterus may also appear.
Even if a pregnant woman has high blood pressure due to some reason, the damage to the inner layer of the blood vessel and excessive constriction of the blood vessel has a negative effect on many organs of the pregnant woman (skin, kidney, blood vessels, liver, stomach, heart, lungs, etc.). In pregnant women suffering from high blood pressure, liver function, kidney function and uric acid, hemoglobin, platelets, amount of blood clotting substances, urine test, eye membrane test, fetal weight on ultrasound, amount of water around it, blood flow in umbilical and sacral blood vessels, etc. should be tested.
A pregnant woman's blood pressure ranges from 160 to 110 or higher, and blood pressure problems are classified as normal or severe. Women with serious blood pressure problems should be admitted to the hospital for further examination and treatment. Anti-hypertensive medication should be started to control severe blood pressure. If severe blood pressure is not treated on time, tremors may occur in pregnant women. In such a situation, the life of both mother and child is at risk.
If a pregnant woman's blood pressure is not controlled despite various treatments, delivery should be attempted. Normal delivery or cesarean operation is decided based on the duration of pregnancy, the maturity of the lungs of the fetus and the position of the cervix.
What is Eclampsia?
If high blood pressure during pregnancy is not controlled early or complications of high blood pressure increase, tremors may become a problem. It is called eclampsia in medical language. If there is a problem with tremors, it should be treated in the hospital under the supervision of a specialist. Women with severe blood pressure problems are more likely to develop eclampsia, but some people with normal blood pressure also develop eclampsia.
Because pregnant women suffering from high blood pressure are often brought to the hospital for treatment, according to hospital statistics, complications such as tremors (eclampsia) occur in one out of 30 to 500 women with high blood pressure. In pregnant women, besides high blood pressure, swelling of the knees, headache, sleep disturbances, burning in the upper part of the stomach, blurred vision, abnormal weight gain are the precursors of eclampsia.
In pregnant women, due to high blood pressure, reduced blood flow to the placenta, swelling of the placenta or disturbances in the electrical activity of the placenta are considered to be the cause of tremors. In about 50 percent of pregnant women, such tremors do not start labor pain, but in 30 percent during labor and in 20 percent after 7 days (usually within 48 hours) of having a baby. Epilepsy, hysteria, encephalitis, meningitis, blood clots in the udder's blood vessels, poisoning, malaria that can affect the udder are other reasons that can cause tremors in pregnant women, but eclampsia should be considered as the main cause of tremors until other causes are found.
Eclampsia Symptoms
Even when the tremors of eclampsia come, like in normal epilepsy, the patient's behavior changes, the body becomes stiff, the tremors go away and faints. Like high blood pressure, eclampsia also negatively affects the kidneys, blood vessels, liver, kidneys, heart, lungs, etc. of a pregnant woman. Once the vibration occurs, the health of the pregnant woman and the fetus cannot be said to be the same. Delayed onset of tremors to treatment, prolonged delivery, more than 10 episodes of tremors, high fever (over 102 degrees), pulse rate over 120, elevated blood pressure over 200, decreased urination, no response to medical treatment Or if jaundice appears - then it should be understood that the situation is not good.
A woman with eclampsia may die prematurely due to heart failure, swelling of the lungs, fainting after vomiting, bleeding in the udder, no urine at all, unconsciousness or infection, and due to premature birth, separation of the placenta due to pre-birth tremors, and insufficient blood (oxygen) to the fetus. Due to the lack of supply, the negative effects of drugs given to the mother to prevent tremors, and the need for surgery to deliver the baby, there is a higher chance of death of the fetus.
Treatment of Eclampsia
Treatment of patients with eclampsia should be done only under the supervision of a specialist. Since there will be a situation where the infant needs to be treated in the intensive care unit, the health workers in remote areas should also carry out the first aid procedure and refer as much as possible.
During this process, until reaching the relevant hospital, you should lie on your left side, pull your chin a little, do not put any foreign object in your mouth because your lips are bitten, keep your breathing easy, give oxygen, administer saline, and place a urinary tube.
If diazepam and other sleep-inducing drugs are given to prevent tremors, the fetus will be negatively affected. Therefore, in order to avoid frequent tremors, a suitable anti-vibration medicine called magnesium sulfate should be given. Having eclampsia means delivery should be done within 12 hours after the tremors stop, so you should be taken to the hospital as soon as possible.
In the hospital, women with eclampsia also undergo blood tests such as liver function, kidney function, platelets, amount of blood clotting material, uric acid, albumin in the urine and how much it is, retinal examination, ultrasound i.e. video X-ray and other lab tests.
Labor pains have already started in patients who have lost tremors. Therefore, after being brought to the hospital, the expert doctor involved in the treatment, after looking at the period of pregnancy and the nature of the cervix, determines whether or not it can be obtained through the vagina or whether a cesarean operation is needed.
Conclusion:
During pregnancy, it is difficult to lower blood pressure as long as the placenta remains in the uterus, and after delivery, after the placenta comes out, there will be frequent tremors and the blood pressure will return to normal, so if a pregnant woman with high blood pressure develops other problems such as eclampsia, there should be no unnecessary delay in delivering the baby (alive or dead). In this type of patient, problems such as infection appear even after delivery and since such problems may recur in subsequent pregnancies, the patient should be well advised when the patient is cured and discharged. Also, after 2 weeks of delivery, blood pressure should be checked by a physician and after 6 weeks, a post-delivery check-up must be done.